CDG-Op/Pedo

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CDG-OP/PEDO

Practice address

10393 Torre Ave Ste L
Cupertino, CA 95014-3235

Phone

(408) 446-4353

NPI assigned

Jan 13, 2023

Organization subpart

No

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

Authorized official

Name

Melina Lucchini

Title

Supervisor

Phone

(408) 508-7528

Specialties & licenses 1

Addresses

Other names 1

• Cupertino Pediatric Dentistry Other name

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673568000000",
    "number": "1255045282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10383 TORRE AVE STE I",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143297",
            "telephone_number": "408-257-3031",
            "fax_number": "408-257-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10393 TORRE AVE STE L",
            "city": "CUPERTINO",
            "state": "CA",
            "postal_code": "950143235",
            "telephone_number": "408-446-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDG-OP/PEDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "LUCCHINI",
        "authorized_official_first_name": "MELINA",
        "authorized_official_title_or_position": "SUPERVISOR",
        "authorized_official_telephone_number": "408-508-7528"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cupertino Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lisa R Carr, LCSW
• Sandra V Carrubba, LMFT
• Tyrone Lee Carter
• Lindsay Victoria Case, DPT
• Ariana Cazares, BCBA, MS
• Franklin Cedeno
• Rocky Cedeno
• Century Radiology Medical Group, Inc
• Corinne Michelle Cerruti, LMFT
• Sul Gi Chae

• Pediatric Dentistry in Cupertino, CA
• Providers in Cupertino, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.