NPIMap

Organization Active NPI

Charles Dental Group

  • Dentist
  • Fair Oaks, CA
National Provider Identifier
1245634682
Registry record updated Oct 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40472 Issued in CA
Legal business name
CHARLES DENTAL GROUP
Practice address
12344 Fair Oaks Blvd Ste a
Fair Oaks, CA 95628-2546
Phone
(916) 721-3367
Fax
(916) 583-7445
NPI assigned
Oct 14, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2014

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

Authorized official

Name
Dr. Blair Vernal Moser II, DDSNPI 1245320498
Title
Owner
Phone
(916) 721-3368

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
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 40472 CA Primary

Addresses

Primary practice location

12344 Fair Oaks Blvd Ste a
Fair Oaks, CA 95628-2546

Mailing address

12344 Fair Oaks Blvd Ste a
Fair Oaks, CA 95628-2546
Phone (916) 721-3367

Other names 1

  • Charles, Moser and Salvatierra Partnership Former legal business name

National Provider Directory

National Provider Directory

Locations

12344 Fair Oaks Blvd
Ste A
Fair Oaks, CA 95628
Phone (916) 721-3368

Practitioners & affiliated clinicians

Practitioners 4

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": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1245634682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12344 FAIR OAKS BLVD STE A",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282546",
            "telephone_number": "916-721-3367",
            "fax_number": "916-583-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12344 FAIR OAKS BLVD STE A",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956282546",
            "telephone_number": "916-721-3367",
            "fax_number": "916-583-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "MOSER",
        "authorized_official_first_name": "BLAIR",
        "authorized_official_middle_name": "VERNAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-721-3368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles, Moser and Salvatierra Partnership",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.