Organization Active NPI

East Sacramento Modern Dentistry, Prof. Corp

Doing business as East Sacramento Modern Dentistry

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1073425484
Registry record updated Sep 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EAST SACRAMENTO MODERN DENTISTRY, PROF. CORP
Doing business as
East Sacramento Modern Dentistry
Practice address
5650 Folsom Blvd
Sacramento, CA 95819-4606
Phone
(279) 221-8240
Fax
(279) 205-2423
NPI assigned
Sep 21, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2026

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

Authorized official

Name
Nazanin Abdehoo, DMD
Title
Owner
Phone
(279) 221-8240

Specialties & licenses 1

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

Addresses

Primary practice location

5650 Folsom Blvd
Sacramento, CA 95819-4606

Mailing address

PO Box 660041
Dallas, TX 75266-0041
Phone (714) 845-8890

Other names 1

  • East Sacramento Modern Dentistry Doing business as

NPI Registry JSON

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

{
    "created_epoch": "1789948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789948800000",
    "number": "1073425484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660041",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752660041",
            "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": "5650 FOLSOM BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958194606",
            "telephone_number": "279-221-8240",
            "fax_number": "279-205-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SACRAMENTO MODERN DENTISTRY, PROF. CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-21",
        "last_updated": "2026-09-21",
        "certification_date": "2026-09-21",
        "status": "A",
        "authorized_official_last_name": "ABDEHOO",
        "authorized_official_first_name": "NAZANIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "279-221-8240",
        "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": "East Sacramento Modern Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.