NPIMap

Organization Active NPI

Bautista and Patel Dental

  • General Practice Dentistry
  • Santa Rosa, CA
National Provider Identifier
1053982439
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BAUTISTA AND PATEL DENTAL
Doing business as
Dentists of Santa Rosa Dental Group
Practice address
370 Coddingtown Ctr
Santa Rosa, CA 95401-3507
Phone
(707) 867-1310
Fax
(707) 921-1398
NPI assigned
Jul 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Varsha Ahuja, DMD
Title
Owner
Phone
(707) 867-1310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

370 Coddingtown Ctr
Santa Rosa, CA 95401-3507

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 845-8890

Other names 1

  • Dentists of Santa Rosa Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

370 Coddingtown Ctr
Santa Rosa, CA 95401
Phone (707) 867-1310

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1053982439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 CODDINGTOWN CTR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954013507",
            "telephone_number": "707-867-1310",
            "fax_number": "707-921-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAUTISTA AND PATEL DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-07",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "AHUJA",
        "authorized_official_first_name": "VARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-867-1310",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of Santa Rosa Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.

Verify at the official NPI Registry.