NPIMap

Organization Active NPI

University California Davis Medical Center, University Dental Assoc

  • Prosthodontics
  • Sacramento, CA
National Provider Identifier
1316944465
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
23361 Issued in CA
Legal business name
UNIVERSITY CALIFORNIA DAVIS MEDICAL CENTER, UNIVERSITY DENTAL ASSOC
Practice address
2521 Stockton Blvd
Sacramento, CA 95817-2207
Phone
(916) 734-5408
Fax
(916) 734-1299
NPI assigned
Jul 5, 2005
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
Dr. Robert Lyons, DDS
Title
Director Dental Clinic
Phone
(916) 734-5408

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 23361 CA Primary

Addresses

Primary practice location

2521 Stockton Blvd
Sacramento, CA 95817-2207

Mailing address

2521 Stockton Blvd
Sacramento, CA 95817-2207
Phone (916) 734-5408

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

NPI Registry JSON

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316944465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-5408",
            "fax_number": "916-734-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-5408",
            "fax_number": "916-734-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY CALIFORNIA DAVIS MEDICAL CENTER, UNIVERSITY DENTAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "DIRECTOR DENTAL CLINIC",
        "authorized_official_telephone_number": "916-734-5408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "23361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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.