S Tenggren Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

S TENGGREN DENTAL CORP

Doing business as

Simi Hills Dental

Practice address

2796 Sycamore Dr
Ste 200
Simi Valley, CA 93065-1546

Phone

(805) 306-0200

Fax

(805) 306-0221

NPI assigned

Nov 6, 2014

Last updated

Nov 6, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Roy Bailey

Title

Coo

Phone

(805) 306-0200

Specialties & licenses 1

Addresses

Other names 1

• Simi Hills Dental Doing business as

Locations

Practitioners 1

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.

• Justin Stout, DMD

  • Dentist
  • Simi Valley, CA
  • NPI 1699053017
  NPD (past)

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

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1245636034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2796 SYCAMORE DR",
            "address_2": "STE 200",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651546",
            "telephone_number": "805-306-0200",
            "fax_number": "805-306-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2796 SYCAMORE DR",
            "address_2": "STE 200",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930651546",
            "telephone_number": "805-306-0200",
            "fax_number": "805-306-0221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S TENGGREN DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "805-306-0200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simi Hills Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelby Russell
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• Courtney Ryan
• Lyndsey Ryburn, MOT, OTR/L
• John Ilsun Ryu, O.D.
• Joseph Zeta Sabino
• Marcia E Sack, MSRD
• Sack's Medical Nutrition Therapy, Inc.
• Marjan Sadeghi
• Mojgan Sadeghi, MD

• General Practice Dentistry in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.