North Jackson Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

23951 Issued in CA

Legal business name

NORTH JACKSON DENTAL GROUP

Practice address

125 N Jackson Ave
Suite #104
San Jose, CA 95116

Phone

(408) 923-8272

Fax

(408) 923-8211

NPI assigned

Jul 30, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Hue My To, DDSNPI 1275665267

Title

Vice President of the Corporation

Phone

(408) 923-8272

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Hue My To, DDS

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1275665267
  NPD (past) Authorized official
• Kimuyen Hanh Huynh, D.D.S

  • Dentist
  • San Jose, CA
  • NPI 1538291299
  NPD (past)
• Tuong Huu Nguyen, DDS

  • General Practice Dentistry
  • San Jose, CA
  • NPI 1508998501
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023023884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 N JACKSON AVE",
            "address_2": "SUITE #104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95116",
            "telephone_number": "408-923-8272",
            "fax_number": "408-923-8211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 N JACKSON AVE",
            "address_2": "SUITE #104",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95116",
            "telephone_number": "408-923-8272",
            "fax_number": "408-923-8211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JACKSON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TO",
        "authorized_official_first_name": "HUE",
        "authorized_official_middle_name": "MY",
        "authorized_official_title_or_position": "VICE PRESIDENT OF THE CORPORATION",
        "authorized_official_telephone_number": "408-923-8272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "23951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9089201",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarah Northrup Gadus

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.