Active NPI
Tasker & Rowan Dental Corporation of Modesto
- Orthodontics and Dentofacial Orthopedics Dentistry
- Modesto, CA
National Provider Identifier
1295469716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 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
National Provider Directory
National Provider DirectoryLocations
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.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Modesto, CA
- NPI 1831823954
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Modesto, CA
- NPI 1104044312
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.