NPIMap

Organization Active NPI

Veaco MD DDS George DDS Arredondo DDS a Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Stockton, CA
National Provider Identifier
1063685303
Registry record updated Mar 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
C2845379 Issued in CA
Legal business name
VEACO MD DDS GEORGE DDS ARREDONDO DDS A DENTAL CORPORATION
Doing business as
Brookside Oral & Maxillofacial Surgery
Practice address
3427 Deer Park Dr
Sutie B
Stockton, CA 95219-2355
Phone
(209) 951-9045
Fax
(209) 951-9047
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2009

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

Authorized official

Name
Dr. Nicolas S Veaco, MD, DDSNPI 1992810337
Title
President
Phone
(209) 951-9045

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X C2845379 CA Primary

Addresses

Primary practice location

3427 Deer Park Dr
Sutie B
Stockton, CA 95219-2355

Mailing address

3427 Deer Park Dr
Sutie B
Stockton, CA 95219-2355
Phone (209) 951-9045

Other names 1

  • Brookside Oral & Maxillofacial Surgery Doing business as

National Provider Directory

National Provider Directory

Locations

1902 N Tracy Blvd
Tracy, CA 95376
Phone (209) 650-3675

Practitioners & affiliated clinicians

Practitioners 3

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": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237507200000",
    "number": "1063685303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 DEER PARK DR",
            "address_2": "SUTIE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192355",
            "telephone_number": "209-951-9045",
            "fax_number": "209-951-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3427 DEER PARK DR",
            "address_2": "SUTIE B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192355",
            "telephone_number": "209-951-9045",
            "fax_number": "209-951-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEACO MD DDS GEORGE DDS ARREDONDO DDS A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2009-03-20",
        "status": "A",
        "authorized_official_last_name": "VEACO",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-951-9045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "C2845379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Oral & Maxillofacial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2009; 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.