Andrew Van Sicklen DDS Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ANDREW VAN SICKLEN DDS INC.

Doing business as

Surfin Smiles

Practice address

1105 E Foster Rd Ste a
Santa Maria, CA 93455-6400

Phone

(805) 332-3076

NPI assigned

Feb 25, 2020

Last updated

Feb 25, 2020By 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

Dr. Andrew Van Sicklen, DDS

Title

Owner

Phone

(805) 423-4481

Specialties & licenses 1

Addresses

Other names 1

• Surfin Smiles Doing business as

Locations

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1306470711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3667 JOHNSON AVE",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934015959",
            "telephone_number": "805-423-4481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 E FOSTER RD STE A",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934556400",
            "telephone_number": "805-332-3076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDREW VAN SICKLEN DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "VAN SICKLEN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-423-4481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surfin Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roxana Jean Anderson
• Samantha Anderson, ASW
• Alyse Micaela Andrade, RN IBCLC
• Romanda Andrade
• Andrew Millar PHD and Teri White PHD Dba Psychology Center of Santa Ma (Psychology Center of Santa Maria)
• Amanda Andrews
• Jenny Oleta Andrews, PA
• Steven Andrews, PA
• Anesthesia Medical Group of Santa Maria Inc
• Jacqueline Angeles Martinez

• Dental Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.