NPIMap

Organization Active NPI

Ask, Kinzer, Simpson, and Roda a Professiona Dental Corp

  • General Practice Dentistry
  • Jackson, CA
National Provider Identifier
1124270137
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
26949 Issued in CA
Legal business name
ASK, KINZER, SIMPSON, AND RODA A PROFESSIONA DENTAL CORP
Practice address
100 French Bar Rd
Suite 101
Jackson, CA 95642-2557
Phone
(209) 223-2712
Fax
(209) 223-2719
NPI assigned
Oct 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Mr. Ron Mihran Ask, D.D.S.
Title
Chief Financial Officer
Phone
(209) 223-2096

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 26949 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 033946 CA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 40117 CA
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 41781 CA

Addresses

Primary practice location

100 French Bar Rd
Suite 101
Jackson, CA 95642-2557

Mailing address

100 French Bar Rd
Suite 101
Jackson, CA 95642-2557
Phone (209) 223-2712

Other names 1

  • Jackson Creek Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Amador Dental Specialties2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

100 French Bar Rd
Ste 101
Jackson, CA 95642
Phone (209) 223-2712

Practitioners 5

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": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1124270137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 FRENCH BAR RD",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422557",
            "telephone_number": "209-223-2712",
            "fax_number": "209-223-2719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 FRENCH BAR RD",
            "address_2": "SUITE 101",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956422557",
            "telephone_number": "209-223-2712",
            "fax_number": "209-223-2719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASK, KINZER, SIMPSON, AND RODA A PROFESSIONA DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "ASK",
        "authorized_official_first_name": "RON",
        "authorized_official_middle_name": "MIHRAN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "209-223-2096",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "26949",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "033946",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40117",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackson Creek Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackson, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.