Dentistar Comprehensive Dental Care, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

58619 Issued in CA

Legal business name

DENTISTAR COMPREHENSIVE DENTAL CARE, INC.

Practice address

111 Deerwood Rd
Suite 350
San Ramon, CA 94583-4409

Phone

(925) 718-8970

Fax

(925) 718-8971

NPI assigned

Mar 25, 2016

Organization subpart

No

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

Authorized official

Name

Steve G Kim, D.D.S.NPI 1013210426

Title

President

Phone

(310) 963-1316

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Steve G Kim, D.D.S.

  • General Practice Dentistry
  • San Ramon, CA
  • NPI 1013210426
  NPD (past) Authorized official

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1063874329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD",
            "address_2": "SUITE 350",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-718-8970",
            "fax_number": "925-718-8971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DEERWOOD RD",
            "address_2": "SUITE 350",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945834409",
            "telephone_number": "925-718-8970",
            "fax_number": "925-718-8971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTISTAR COMPREHENSIVE DENTAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "STEVE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-963-1316",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna M Demott
• Haiying Deng, MASTER OF TCM
• Robin Marcellus Dennings, M.D.
• Grace Dent
• Dentabliss Dental
• Rashpal S. Deol, DDS
• Julia Derenzi, PA
• Nehaben Desai, NP
• Patrick E Desrosiers, D.P.T.
• Destiny Behavioral Health

• General Practice Dentistry in San Ramon, CA
• Providers in San Ramon, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.