NPIMap

Organization Active NPI

Fouladi Professional Dental Corp.

  • Oral and Maxillofacial Surgery (Dentist)
  • Roseville, CA
National Provider Identifier
1235871450
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FOULADI PROFESSIONAL DENTAL CORP.
Doing business as
Sacramento Oral Surgery Roseville
Practice address
1603 Eureka Rd Ste 100
Roseville, CA 95661-3028
Phone
(916) 782-6868
Fax
(916) 782-6878
NPI assigned
Apr 8, 2022
Organization subpart
Yes
Parent organization
FOULADI PROFESSIONAL DENTAL CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordiantor
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

1603 Eureka Rd Ste 100
Roseville, CA 95661-3028

Mailing address

1603 Eureka Rd Ste 100
Roseville, CA 95661-3028
Phone (916) 782-6868

Other names 1

  • Sacramento Oral Surgery Roseville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fouladi Professional Dental Corp4 organizations share this tax ID, including this one
Part of
Fouladi Professional Dental Corp

Other organizations with this tax ID 3

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

Locations

1603 Eureka Rd
Ste 100
Roseville, CA 95661
Phone (916) 782-6868

Practitioners & affiliated clinicians

Practitioners 2

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": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1235871450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1603 EUREKA RD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613028",
            "telephone_number": "916-782-6868",
            "fax_number": "916-782-6878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1603 EUREKA RD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613028",
            "telephone_number": "916-782-6868",
            "fax_number": "916-782-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOULADI PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOULADI PROFESSIONAL DENTAL CORP.",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDIANTOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacramento Oral Surgery Roseville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 8, 2022; 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.