NPIMap

Organization Active NPI

Capitol Periodontal Group

  • Periodontics
  • Roseville, CA
National Provider Identifier
1235321852
Registry record updated Aug 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
CAPITOL PERIODONTAL GROUP
Practice address
2428 Professional Dr
Ste 100
Roseville, CA 95661-7774
Phone
(916) 786-6585
Fax
(916) 786-7542
NPI assigned
Aug 16, 2007
Last updated
Aug 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2007

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

Authorized official

Name
Susan Dilworth
Title
Financial Assistant
Phone
(916) 394-6555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X NU Primary

Addresses

Primary practice location

2428 Professional Dr
Ste 100
Roseville, CA 95661-7774

Mailing address

PO Box 255727
Sacramento, CA 95865-5727
Phone (916) 394-6555

National Provider Directory

National Provider Directory
Tax ID family
Capitol Periodontal Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

2428 Professional Dr
Ste 100
Roseville, CA 95661
Phone (916) 786-6585

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1235321852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255727",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655727",
            "telephone_number": "916-394-6555",
            "fax_number": "916-394-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2428 PROFESSIONAL DR",
            "address_2": "STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617774",
            "telephone_number": "916-786-6585",
            "fax_number": "916-786-7542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITOL PERIODONTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "DILWORTH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "FINANCIAL ASSISTANT",
        "authorized_official_telephone_number": "916-394-6555"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.