Active NPI
Dr.'S Shturman, Michelson and Kisilyuk a Dental Corporation
- Dentist
- San Rafael, CA
National Provider Identifier
1205129624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 45975
- Legal business name
- DR.'S SHTURMAN, MICHELSON AND KISILYUK A DENTAL CORPORATION
- Practice address
- 1050 Northgate Dr
250B
San Rafael, CA 94903-2526 - Phone
- (415) 306-1456
- NPI assigned
- May 18, 2011
- Last updated
- May 18, 2011
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Christine Campbell
- Title
- Office Administrator
- Phone
- (916) 737-6453
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 45975 | CA | Primary |
Addresses
Primary practice location
1050 Northgate Dr
250B
San Rafael, CA 94903-2526
Mailing address
1050 Northgate Dr
250B
San Rafael, CA 94903-2526
Phone (415) 306-1456
Other names 1
- Dental Medicine Providers
National Provider Directory
National Provider Directory- Tax ID family
- Dental Medicine Providers
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305676800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1305676800000",
"number": "1205129624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"address_2": "250B",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032526",
"telephone_number": "415-306-1456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1050 NORTHGATE DR",
"address_2": "250B",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032526",
"telephone_number": "415-306-1456"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR.'S SHTURMAN, MICHELSON AND KISILYUK A DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2011-05-18",
"last_updated": "2011-05-18",
"status": "A",
"authorized_official_last_name": "CAMPBELL",
"authorized_official_first_name": "CHRISTINE",
"authorized_official_title_or_position": "OFFICE ADMINISTRATOR",
"authorized_official_telephone_number": "916-737-6453",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "45975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dental Medicine Providers",
"code": "5",
"type": "Other Name"
}
]
}Other providers in San Rafael, CA
- Kendra Thompson Downey, RN NP
- Brianna Doyle, RADT
- Elizabeth M. Doyle
- Dr Michael Y Chew OD
- Dr. Molly Koehler, Professional Corporation (Marin Direct Primary Care Medical Clinic with Dr. Molly Koehler)
- Scott Dragoman, PHARMD, RPH
- Emily Drake
- Drew E Maris MD Professional Corporation
- Stephen Drew, PH.D.
- Briana Eve Drimmer, ED.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.