Interdental Care

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47082 Issued in CA

Legal business name

INTERDENTAL CARE

Practice address

106 N Sunrise Ave
Suite B-10
Roseville, CA 95661-2906

Phone

(916) 878-0631

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Mariano Wendell Guerra, DDSNPI 1417142993

Title

Dentist

Phone

(916) 787-0631

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.

• Mariano W Guerra, DDS

  • Dentist
  • Roseville, CA
  • NPI 1417142993
  NPD (past) Authorized official

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093840696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 N SUNRISE AVE STE B10",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612915",
            "telephone_number": "916-787-0631",
            "fax_number": "916-787-3277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 N SUNRISE AVE",
            "address_2": "SUITE B-10",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612906",
            "telephone_number": "916-878-0631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERDENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUERRA",
        "authorized_official_first_name": "MARIANO",
        "authorized_official_middle_name": "WENDELL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "916-787-0631",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Roseville, CA
• Providers in Roseville, 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 Aug 22, 2020; 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.