NPIMap

Organization Active NPI

Goleta Neighborhood Dental Clinic

  • Dental Clinic/Center
  • Goleta, CA
National Provider Identifier
1144636291
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
GOLETA NEIGHBORHOOD DENTAL CLINIC
Practice address
164 Kinman Ave
Goleta, CA 93117-3481
Phone
(805) 617-7900
Fax
(805) 617-7899
NPI assigned
Jul 9, 2014
Last updated
Mar 3, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
SANTA BARBARA NEIGHBORHOOD CLINICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Dr. Charles Camillo Fenzi, M.D.
Title
Chief Executive Officer
Phone
(805) 617-7850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

164 Kinman Ave
Goleta, CA 93117-3481

Mailing address

915 N Milpas St
2ND Floor
Santa Barbara, CA 93103-2331
Phone (805) 617-7850

National Provider Directory

National Provider Directory
Tax ID family
Santa Barbara Neighborhood15 organizations share this tax ID, including this one
Part of
Santa Barbara Neighborhood

Other organizations with this tax ID 14

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

View all 14

Locations

164 Kinman Ave
Santa Barbara, CA 93117
Phone (805) 617-7898

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1144636291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 N MILPAS ST",
            "address_2": "2ND FLOOR",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931032331",
            "telephone_number": "805-617-7850",
            "fax_number": "805-963-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 KINMAN AVE",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931173481",
            "telephone_number": "805-617-7900",
            "fax_number": "805-617-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLETA NEIGHBORHOOD DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SANTA BARBARA NEIGHBORHOOD CLINICS",
        "enumeration_date": "2014-07-09",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "FENZI",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "CAMILLO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "805-617-7850",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goleta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.