NPIMap

Organization Active NPI

William G.Low DDS a Professional Dental Corp

  • General Practice Dentistry
  • Stockton, CA
National Provider Identifier
1184818569
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
WILLIAM G.LOW DDS A PROFESSIONAL DENTAL CORP
Practice address
1341 N El Dorado St
Stockton, CA 95202-1016
Phone
(209) 465-5747
Fax
(206) 465-3602
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Authorized official

Name
Dr. Everett Leman Low, DDSNPI 1013042688
Title
Secretary/Treasurer
Phone
(209) 465-5747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1341 N El Dorado St
Stockton, CA 95202-1016

Mailing address

1341 N El Dorado St
Stockton, CA 95202-1016
Phone (209) 465-5747

Other identifiers 1

IdentifierTypeStateIssuer
26885-01MedicaidCA

Other names 1

  • A Professional Dental Corp. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
William Glow DDS a Professional Dental Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1341 N El Dorado St
Stockton, CA 95202
Phone (209) 465-5747

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570665600000",
    "number": "1184818569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 N EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021016",
            "telephone_number": "209-465-5747",
            "fax_number": "206-465-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N EL DORADO ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021016",
            "telephone_number": "209-465-5747",
            "fax_number": "206-465-3602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM G.LOW DDS A PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2019-10-10",
        "status": "A",
        "authorized_official_last_name": "LOW",
        "authorized_official_first_name": "EVERETT",
        "authorized_official_middle_name": "LEMAN",
        "authorized_official_title_or_position": "SECRETARY/TREASURER",
        "authorized_official_telephone_number": "209-465-5747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "26885-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Professional Dental Corp.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "A Professional Dental Corp.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.