Inna Shturman, D.D.S. a Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45975 Issued in CA

Legal business name

INNA SHTURMAN, D.D.S. A PROFESSIONAL CORPORATION

Doing business as

The Smile Doctor

Practice address

3000 L St
Suite 104
Sacramento, CA 95816-5248

Phone

(916) 737-6453

Fax

(916) 737-3075

NPI assigned

Jul 6, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Chris Campbell

Title

Office Manager

Phone

(916) 737-6453

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Smile Doctor Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1184822462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 L ST",
            "address_2": "SUITE 104",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165248",
            "telephone_number": "916-737-6453",
            "fax_number": "916-737-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 L ST",
            "address_2": "SUITE 104",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958165248",
            "telephone_number": "916-737-6453",
            "fax_number": "916-737-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNA SHTURMAN, D.D.S. A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-737-6453",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE #",
            "identifier": "45975",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Smile Doctor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Sacramento, CA
• Providers in Sacramento, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.