San Pablo Dental Center Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SAN PABLO DENTAL CENTER INC

Practice address

11100 San Pablo Ave Ste 107
El Cerrito, CA 94530-2172

Phone

(510) 233-9022

NPI assigned

Apr 25, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Susan Galvan

Title

President

Phone

(408) 627-1628

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1174211445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 SAN PABLO AVE STE 107",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945302172",
            "telephone_number": "510-233-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SAN PABLO AVE STE 107",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945302172",
            "telephone_number": "510-233-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PABLO DENTAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "GALVAN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-627-1628",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Leopi Nicola Sanderson-Edmunds, LM, CPM

• Dental Clinic/Center in El Cerrito, CA
• Providers in El Cerrito, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; 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.