NPIMap

Organization Active NPI

UC Davis Univ Dental Associates

  • Special Hospital
  • Sacramento, CA
National Provider Identifier
1285774109
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
Legal business name
UC DAVIS UNIV DENTAL ASSOCIATES
Practice address
2521 Stockton Blvd
Room 5200
Sacramento, CA 95817-2207
Phone
(916) 734-5408
Fax
(916) 734-4960
NPI assigned
Feb 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Miss Maryt Hunter, R.D.A..
Title
Registered Dental Assistant
Phone
(916) 734-5408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X Primary

Addresses

Primary practice location

2521 Stockton Blvd
Room 5200
Sacramento, CA 95817-2207

Mailing address

PO Box 60000
San Francisco, CA 94160-0001
Phone (916) 734-5408

Other identifiers 1

IdentifierTypeStateIssuer
G01073-01MedicaidCA

Other names 1

  • UNIVERSITY DENTAL ASSOCIATES Other name

National Provider Directory

National Provider Directory
Tax ID family
Ucd Med GRP Pediatric32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

2521 Stockton Blvd
Rm 5200
Sacramento, CA 95817
Phone (916) 734-5408

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285774109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941600001",
            "telephone_number": "916-734-5408",
            "fax_number": "916-734-4960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "address_2": "ROOM 5200",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-5408",
            "fax_number": "916-734-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UC DAVIS UNIV DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "MARYT",
        "authorized_official_title_or_position": "REGISTERED DENTAL ASSISTANT",
        "authorized_official_telephone_number": "916-734-5408",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "R.D.A.."
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G01073-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UNIVERSITY DENTAL ASSOCIATES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.