NPIMap

Organization Active NPI

County of Santa Clara

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1205915501
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COUNTY OF SANTA CLARA
Practice address
500 Tully Rd
Ronald McDonald Dental Mobile Unit
San Jose, CA 95111-1917
Phone
(408) 885-5000
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Alfonso F Banuelos Jr., MD
Title
Chief Medical Officer
Phone
40888854001

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X CA
Federally Qualified Health Center (FQHC) 261QF0400X CA Primary

Addresses

Primary practice location

500 Tully Rd
Ronald McDonald Dental Mobile Unit
San Jose, CA 95111-1917

Mailing address

PO Box 5280
Patient Business Services
San Jose, CA 95150-5280
Phone (408) 885-5000

Other identifiers 1

IdentifierTypeStateIssuer
FHC80060FMedicaidCA

Other names 1

  • Ronald McDonald Dental Mobile Unit Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Scvhhsaep174 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1205915501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5280",
            "address_2": "PATIENT BUSINESS SERVICES",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951505280",
            "telephone_number": "408-885-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TULLY RD",
            "address_2": "RONALD MCDONALD DENTAL MOBILE UNIT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951111917",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SANTA CLARA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BANUELOS",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "40888854001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FHC80060F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ronald McDonald Dental Mobile Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.