Family Dental Practice of Roseville

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

29786 Issued in CA

Legal business name

FAMILY DENTAL PRACTICE OF ROSEVILLE

Practice address

4014 Foothills Blvd
Suite 103
Roseville, CA 95747-7233

Phone

(916) 773-4343

Fax

(916) 773-4348

NPI assigned

Mar 8, 2007

Last updated

Aug 22, 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

Mark D Phipps, D.D.S.

Title

Owner

Phone

(916) 773-4343

Specialties & licenses 1

Addresses

Locations

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.

• Brandon McKay Dever, DDS

  • General Practice Dentistry
  • Roseville, CA
  • NPI 1760568729
  NPD (past)

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326179631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4014 FOOTHILLS BLVD",
            "address_2": "SUITE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957477233",
            "telephone_number": "916-773-4343",
            "fax_number": "916-773-4348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4014 FOOTHILLS BLVD",
            "address_2": "SUITE 103",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957477233",
            "telephone_number": "916-773-4343",
            "fax_number": "916-773-4348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL PRACTICE OF ROSEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PHIPPS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-773-4343",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Kathleen Fahy, IMFT
• Tanisha Fairgood, LMFT
• Lauren Koohai Fairley
• Darilyn Campbell Falck, M.D.
• Fall Creek Counceling Associates
• Family Physical Therapy, Inc (Family Physical Therapy)
• Family Solutions Center, Inc
• Courtney Fammartino
• Zhe Fan
• Farzin Farahmandnia, DDS

• General Practice Dentistry in Roseville, CA
• Providers in Roseville, CA by specialty
• General Practice Dentistry in California

• 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.