Organization Active NPI

Pool & Creighton Dental Corporation

  • Dentist
  • San Francisco, CA
National Provider Identifier
1144593682
Registry record updated Mar 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58832 Issued in CA
Legal business name
POOL & CREIGHTON DENTAL CORPORATION
Practice address
1719 Powell St
San Francisco, CA 94133-2808
Phone
(415) 891-9773
Fax
(415) 398-4123
NPI assigned
Feb 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2012

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

Authorized official

Name
Dr. Jared Warren Pool, D.D.S.
Title
President
Phone
(415) 891-9773

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 58832 CA Primary

Addresses

Primary practice location

1719 Powell St
San Francisco, CA 94133-2808

Mailing address

1719 Powell St
San Francisco, CA 94133-2808

Other names 1

  • Washington Square Park Dental Doing business as

National Provider Directory

National Provider Directory

Locations

1719 Powell St
San Francisco, CA 94133
Phone (415) 609-3779

Practitioners & affiliated clinicians

Practitioners 1

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": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331251200000",
    "number": "1144593682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 POWELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941332808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1719 POWELL ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941332808",
            "telephone_number": "415-891-9773",
            "fax_number": "415-398-4123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POOL & CREIGHTON DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-03-09",
        "status": "A",
        "authorized_official_last_name": "POOL",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-891-9773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "58832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Washington Square Park Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2012; 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.