Active NPI
Central Coast Pediatric Dental Group
- Pediatric Dentistry
- Salinas, CA
National Provider Identifier
1033242144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 37400
- Legal business name
- CENTRAL COAST PEDIATRIC DENTAL GROUP
- Practice address
- 945 Blanco Circle Suite D
Salinas, CA 93901 - Phone
- (831) 424-0641
- Fax
- (831) 424-0888
- NPI assigned
- Mar 14, 2007
- Last updated
- Mar 25, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Anna M Lizaola
- Title
- Administrative Assistant
- Phone
- (831) 442-8878
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 37400 | CA | Primary |
Addresses
Primary practice location
945 Blanco Circle Suite D
Salinas, CA 93901
Mailing address
631 E Alvin Drive Suite C
Salinas, CA 93906
Phone (831) 442-8878
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9087501 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Central Coast Pediatric Dental Group
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatric Dentistry
- Salinas, CA
- NPI 1205922705
-
- Pediatric Dentistry
- Seaside, CA
- NPI 1942333059
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616630400000",
"number": "1033242144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "631 E ALVIN DRIVE SUITE C",
"city": "SALINAS",
"state": "CA",
"postal_code": "93906",
"telephone_number": "831-442-8878",
"fax_number": "831-443-4611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 BLANCO CIRCLE SUITE D",
"city": "SALINAS",
"state": "CA",
"postal_code": "93901",
"telephone_number": "831-424-0641",
"fax_number": "831-424-0888"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTRAL COAST PEDIATRIC DENTAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-14",
"last_updated": "2021-03-25",
"certification_date": "2021-03-25",
"status": "A",
"authorized_official_last_name": "LIZAOLA",
"authorized_official_first_name": "ANNA",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
"authorized_official_telephone_number": "831-442-8878"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "37400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G9087501",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salinas, CA
- Central Coast Hand Therapy
- Central Coast Head & Neck Surgeons a M C Inc
- Central Coast Imaging
- Central Coast Interpreters
- Central Coast Nephrology Medical Corporation
- Central Coast Pediatric Dental Group
- Central Coast Vna & Hospice, Inc. (Central Coast VNA and Hospice, Inc.)
- Central Coast Young Men's Christian Association
- Cep America - California (Vituity)
- Cep America - Psychiatry PC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.