NPIMap

Organization Active NPI

Laguna Creek Family Dentistry

  • Dentist
  • Elk Grove, CA
National Provider Identifier
1063703643
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39558 Issued in CA
Legal business name
LAGUNA CREEK FAMILY DENTISTRY
Practice address
5030 Laguna Blvd Ste 108
Elk Grove, CA 95758-4149
Phone
(916) 684-4888
Fax
(916) 684-6999
NPI assigned
Apr 29, 2011
Last updated
Apr 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

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

Authorized official

Name
Dr. Curtis P Pon, DDSNPI 1295849107
Title
Owner
Phone
(916) 684-4888

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
Dentist 122300000X 39558 CA Primary

Addresses

Primary practice location

5030 Laguna Blvd Ste 108
Elk Grove, CA 95758-4149

Mailing address

5030 Laguna Blvd Ste 108
Elk Grove, CA 95758-4149
Phone (916) 684-4888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1304035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304035200000",
    "number": "1063703643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 LAGUNA BLVD STE 108",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584149",
            "telephone_number": "916-684-4888",
            "fax_number": "916-684-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 LAGUNA BLVD STE 108",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584149",
            "telephone_number": "916-684-4888",
            "fax_number": "916-684-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGUNA CREEK FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-29",
        "last_updated": "2011-04-29",
        "status": "A",
        "authorized_official_last_name": "PON",
        "authorized_official_first_name": "CURTIS",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-684-4888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; 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.