Folsom Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

41689 Issued in CA

Legal business name

FOLSOM DENTAL GROUP

Practice address

1840 Prairie City Rd
Suite 200
Folsom, CA 95630-9579

Phone

(916) 351-9808

Fax

(916) 351-9847

NPI assigned

Apr 18, 2008

Last updated

Apr 18, 2008By 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

Steve Samusenko

Title

Office Manager

Phone

(916) 351-9808

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1265606487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1840 PRAIRIE CITY RD",
            "address_2": "SUITE 200",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309579",
            "telephone_number": "916-351-9808",
            "fax_number": "916-351-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 PRAIRIE CITY RD",
            "address_2": "SUITE 200",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309579",
            "telephone_number": "916-351-9808",
            "fax_number": "916-351-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOLSOM DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "SAMUSENKO",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-351-9808"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Folsom Anesthesia Medical Group Inc.
• Folsom Chinese Acupuncture Center
• Folsom Chiropractic LLC (Folsom Chiropractic)
• Folsom City MD (Sac City MD)
• Folsom Countryhouse Op Co LLLP (CountryHouse Folsom)
• Folsom Dermatology
• Folsom Endoscopy Center LLC (Folsom Sierra Endoscopy Center)
• Folsom Family and Sports Medical Group Inc.
• Folsom in-Patient Medical Group
• Folsom Lake Primary Care PC

• General Practice Dentistry in Folsom, CA
• Providers in Folsom, 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 Apr 18, 2008; 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.