NPIMap

Organization Active NPI

Sprague, Packham & Pizza Dental Corporation

  • General Practice Dentistry
  • Camarillo, CA
National Provider Identifier
1225168156
Registry record updated Oct 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29105 Issued in CA
Legal business name
SPRAGUE, PACKHAM & PIZZA DENTAL CORPORATION
Doing business as
(dba) Rosewood Dental Group
Practice address
4027 Mission Oaks Blvd
Camarillo, CA 93012-5156
Phone
(805) 484-1022
Fax
(805) 484-3221
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2014

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

Authorized official

Name
Dr. Robert W Sprague, DDSNPI 1861524571
Title
Dentist Ceo
Phone
(805) 484-1022

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 29105 CA Primary

Addresses

Primary practice location

4027 Mission Oaks Blvd
Camarillo, CA 93012-5156

Mailing address

4027 Mission Oaks Blvd
Camarillo, CA 93012-5156
Phone (805) 484-1022

Other identifiers 1

IdentifierTypeStateIssuer
850412 & 781138OtherCAUNITED CONCORDIA

Other names 1

  • (dba) Rosewood Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1225168156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4027 MISSION OAKS BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125156",
            "telephone_number": "805-484-1022",
            "fax_number": "805-484-3221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4027 MISSION OAKS BLVD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125156",
            "telephone_number": "805-484-1022",
            "fax_number": "805-484-3221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRAGUE, PACKHAM & PIZZA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "SPRAGUE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST    CEO",
        "authorized_official_telephone_number": "805-484-1022",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "850412 & 781138",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "(dba) Rosewood Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; 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.