NPIMap

Organization Active NPI

Mark D. Phipps DDS

  • General Practice Dentistry
  • Auburn, CA
National Provider Identifier
1366573222
Registry record updated Aug 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
29786 Issued in CA
Legal business name
MARK D. PHIPPS DDS
Practice address
161 Palm Ave
Suite 12
Auburn, CA 95603-3718
Phone
(530) 885-0697
Fax
(530) 889-5697
NPI assigned
Mar 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2015

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.NPI 1588795249
Title
Owner
Phone
(530) 885-0697

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 29786 CA Primary

Addresses

Primary practice location

161 Palm Ave
Suite 12
Auburn, CA 95603-3718

Mailing address

161 Palm Ave
Suite 12
Auburn, CA 95603-3718
Phone (530) 885-0697

Other identifiers 1

IdentifierTypeStateIssuer
1588795249OtherCAUNDEFINED PHYSICIAN (GENERAL DENTIST)

National Provider Directory

National Provider Directory

Locations

161 Palm Ave
Ste 12
Auburn, CA 95603
Phone (530) 885-0697

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440460800000",
    "number": "1366573222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "161 PALM AVE",
            "address_2": "SUITE 12",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033718",
            "telephone_number": "530-885-0697",
            "fax_number": "530-889-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 PALM AVE",
            "address_2": "SUITE 12",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033718",
            "telephone_number": "530-885-0697",
            "fax_number": "530-889-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK D. PHIPPS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2015-08-25",
        "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": "530-885-0697",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "29786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNDEFINED PHYSICIAN (GENERAL DENTIST)",
            "identifier": "1588795249",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2015; 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.