Powell Pediatric Dentistry Ingram Partnership

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

POWELL PEDIATRIC DENTISTRY INGRAM PARTNERSHIP

Practice address

7761 N Ingram Ave
Suite 101
Fresno, CA 93711

Phone

(559) 431-9701

NPI assigned

Jul 24, 2017

Last updated

Jul 24, 2017By 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

Mr. Brent David Powell, DMD

Title

Managing Partner

Phone

(559) 321-1833

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Sue S Ali

  • Dental Assistant
  • Fresno, CA
  • NPI 1912656349
  NPD (past)
• Belinda Marie Becerra, RDA

  • Dental Assistant
  • Fresno, CA
  • NPI 1427547975
  NPD (past)

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

{
    "created_epoch": "1500854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500854400000",
    "number": "1346763158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7761 N INGRAM AVE",
            "address_2": "SUITE #101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-431-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7761 N INGRAM AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93711",
            "telephone_number": "559-431-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL PEDIATRIC DENTISTRY INGRAM PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-24",
        "last_updated": "2017-07-24",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "559-321-1833",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexei Ivanovich Pouzakov, PA-C
• Phalla Pov-Brantle
• Poverello House
• Antrinique Cashae Powe
• Powell Pediatric Dentistry Chestnut Partnership
• Christopher Relas Powell, DPT
• Elizabeth Powell
• Joshua Clinton Powell, CADTP 16126
• Tamika S Powell
• Power Mental Health Services Inc

• Pediatric Dentistry in Fresno, CA
• Providers in Fresno, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2017; 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.