Organization Active NPI

Yan Kalika Dental Corporation

  • General Practice Dentistry
  • Martinez, CA
National Provider Identifier
1164076410
Registry record updated Sep 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
YAN KALIKA DENTAL CORPORATION
Practice address
582 Center Ave
Martinez, CA 94553-4600
Phone
(510) 626-0111
NPI assigned
Jul 25, 2019
Organization subpart
Yes
Parent organization
YAN KALIKA DENTAL CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 26, 2024

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

Authorized official

Name
Yan Kalika, DMD
Title
President
Phone
(916) 297-6603

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X
Oral & Maxillofacial Surgery (D.M.D.)Group: 193200000X MULTI-SPECIALTY GROUP 204E00000X

Addresses

Primary practice location

582 Center Ave
Martinez, CA 94553-4600

Mailing address

3075 Beacon Blvd
West Sacramento, CA 95691-3462
Phone (916) 297-6603

Other names 2

  • Muir Station Smiles Doing business as
  • Muir Station Smiles Children's Dentistry and Orthodontics Other name

National Provider Directory

National Provider Directory
Tax ID family
Yan Kalika Dental Corporation38 organizations share this tax ID, including this one
Part of
Yan Kalika Dental Corporation

Other organizations with this tax ID 37

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

View all 37

Locations

582 Center Ave
Martinez, CA 94553
Phone (510) 626-0111

NPI Registry JSON

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1164076410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-297-6603",
            "fax_number": "916-384-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 CENTER AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945534600",
            "telephone_number": "510-626-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAN KALIKA DENTAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "YAN KALIKA DENTAL CORPORATION",
        "enumeration_date": "2019-07-25",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "KALIKA",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-297-6603",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Muir Station Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Muir Station Smiles Children's Dentistry and Orthodontics",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2024; 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.