Sergio Vicuna, D.D.S., Inc

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SERGIO VICUNA, D.D.S., INC

Practice address

1804 19TH St
Suite 100
Sacramento, CA 95811

Phone

(916) 246-0889

Fax

(916) 458-8468

NPI assigned

Sep 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Sergio Vicuna, DDS

Title

Owner

Phone

(916) 246-0889

Specialties & licenses 1

Addresses

Other names 1

• Midtown Modern Dental Group Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Achman Singh Jaswal

  • Dentist
  • Sacramento, CA
  • NPI 1033854237
  NPD (past)
• Sarah Mathai, DDS

  • General Practice Dentistry
  • Sacramento, CA
  • NPI 1295221257
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472688000000",
    "number": "1275089963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 19TH ST",
            "address_2": "SUITE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95811",
            "telephone_number": "916-246-0889",
            "fax_number": "916-458-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO VICUNA, D.D.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-01",
        "last_updated": "2016-09-01",
        "status": "A",
        "authorized_official_last_name": "VICUNA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-246-0889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Modern Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serenity Dental Office
• Serenity Wellness Nursing Practice Inc
• Roya Sereshki, PHARMD
• Monique Sergeeff
• Sergey Mahtesyan DDS, Inc
• Rifat Serin
• Andreea Livia Seritan, M.D.
• Arturo Altamirano Sermeno
• Benjamin Vargas Serna I
• Dedita Peralta Serna, PTA

• Dentist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; 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.