Premier Dental Care

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

45761 Issued in CA

Legal business name

PREMIER DENTAL CARE

Practice address

229 N McDowell Blvd
Petaluma, CA 94954-2306

Phone

(707) 766-7373

Fax

(707) 776-7173

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Klaus Johann Radtke, D.D.S.

Title

Dentist

Phone

(415) 225-6675

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144360769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542306",
            "telephone_number": "707-766-7373",
            "fax_number": "707-776-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 N MCDOWELL BLVD",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542306",
            "telephone_number": "707-766-7373",
            "fax_number": "707-776-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RADTKE",
        "authorized_official_first_name": "KLAUS",
        "authorized_official_middle_name": "JOHANN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "415-225-6675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "45761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robin Pride
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• Brent Pritt, DPT
• Pro Ease LLC

• Dental Clinic/Center in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Dental Clinic/Center 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.