Pacific Pediatric Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

54656 Issued in CA

Legal business name

PACIFIC PEDIATRIC DENTISTRY

Practice address

1231 Osos St
San Luis Obispo, CA 93401-3619

Phone

(805) 544-3434

Fax

(805) 544-3443

NPI assigned

Sep 26, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Eun Ha You

Title

Owner

Phone

(805) 544-3434

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1506384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1144739715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1231 OSOS ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013619",
            "telephone_number": "805-544-3434",
            "fax_number": "805-544-3443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 OSOS ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013619",
            "telephone_number": "805-544-3434",
            "fax_number": "805-544-3443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "YOU",
        "authorized_official_first_name": "EUN HA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-544-3434",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "54656",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Central Coast Health Centers
• Pacific Coast Audiology, Inc.
• Pacific Coast Physicians Medical Group
• Pacific Eye Surgeons, a California Professional Medical Corporation
• Pacific Medical, Inc.
• Pacific Point Laboratories, Inc.
• Pacific Psychiatry Inc.
• Pacific Psychiatry Inc., a Professional Medical Corporation
• Pacific Surgery Center of San Luis Obispo, LLC
• Pacifica Slo LLC

• Pediatric Dentistry in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.