NPIMap

Organization Active NPI

S. Jang DDS Incorporated

  • Dentist
  • Granite Bay, CA
National Provider Identifier
1154918944
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
S. JANG DDS INCORPORATED
Practice address
4060 Douglas Blvd Ste 110
Granite Bay, CA 95746-5934
Phone
(916) 260-0704
NPI assigned
Dec 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

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

Authorized official

Name
Megan Castillo
Title
Operations Manager
Phone
(916) 781-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

4060 Douglas Blvd Ste 110
Granite Bay, CA 95746-5934

Mailing address

2260 E Bidwell St # 363
Folsom, CA 95630-3555
Phone (916) 984-4224

Other names 1

  • Smile Time Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
S Jang DDS Incorporated17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

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

View all 16

Locations

2260 E Bidwell St
#363
Folsom, CA 95630

4060 Douglas Blvd
Ste 110
Granite Bay, CA 95746
Phone (916) 260-0646

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613001600000",
    "number": "1154918944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST # 363",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303555",
            "telephone_number": "916-984-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 DOUGLAS BLVD STE 110",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957465934",
            "telephone_number": "916-260-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. JANG DDS INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A",
        "authorized_official_last_name": "CASTILLO",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "916-781-6550"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Time Dental",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Time Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Granite Bay, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; 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.