NPIMap

Organization Active NPI

Reeves, D.D.S. and Lavalley, D.D.S., a Dental Corporation

  • Pediatric Dentistry
  • Stockton, CA
National Provider Identifier
1104264985
Registry record updated Feb 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION
Practice address
3485 Brookside Rd
Ste 101
Stockton, CA 95219-1757
Phone
(209) 957-4386
NPI assigned
Jun 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2023

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

Authorized official

Name
Derek Boyes
Title
Coo
Phone
(916) 570-1500

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

3485 Brookside Rd
Ste 101
Stockton, CA 95219-1757

Mailing address

3100 Zinfandel Dr Ste 400
Rancho Cordova, CA 95670-6391
Phone (916) 570-1500

Other names 1

  • Kids Care Dental & Orthodontics - Stockton Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Reeves DDS and Lavalley DDS a Dental Corporation34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

Organizations that report the same tax identification number in the National Provider Directory.

View all 33

Locations

3485 Brookside Rd
#101
Stockton, CA 95219
Phone (209) 957-4386

Practitioners & affiliated clinicians

Practitioners 2

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": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675900800000",
    "number": "1104264985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 ZINFANDEL DR STE 400",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956706391",
            "telephone_number": "916-570-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3485 BROOKSIDE RD",
            "address_2": "STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952191757",
            "telephone_number": "209-957-4386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REEVES, D.D.S. AND LAVALLEY, D.D.S., A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A",
        "authorized_official_last_name": "BOYES",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "916-570-1500"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kids Care Dental & Orthodontics - Stockton",
            "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 Feb 9, 2023; 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.