Organization Active NPI

Tasker & Rowan Dental Corporation of Modesto

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Modesto, CA
National Provider Identifier
1295469716
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
TASKER & ROWAN DENTAL CORPORATION OF MODESTO
Practice address
4101 Tully Rd Ste 401
Modesto, CA 95356-8982
Phone
(209) 575-5888
NPI assigned
Jul 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Authorized official

Name
Jen Saso
Title
Executive Manager
Phone
(916) 479-3432

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

4101 Tully Rd Ste 401
Modesto, CA 95356-8982

Mailing address

PO Box 961
Elk Grove, CA 95759-0961

Other names 1

  • Champion Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

4101 Tully Rd
Ste 401
Modesto, CA 95356
Phone (209) 575-5888

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1657497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657497600000",
    "number": "1295469716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 961",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957590961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 TULLY RD STE 401",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953568982",
            "telephone_number": "209-575-5888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TASKER & ROWAN DENTAL CORPORATION OF MODESTO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-11",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A",
        "authorized_official_last_name": "SASO",
        "authorized_official_first_name": "JEN",
        "authorized_official_title_or_position": "EXECUTIVE MANAGER",
        "authorized_official_telephone_number": "916-479-3432"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champion Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.