NPIMap

Organization Active NPI

Steele Placerville Dental Group, Inc

  • General Practice Dentistry
  • Placerville, CA
National Provider Identifier
1366862302
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54818 Issued in CA
Legal business name
STEELE PLACERVILLE DENTAL GROUP, INC
Doing business as
Placerville Dentistry Group
Practice address
699 Main St
Suit B
Placerville, CA 95667-5760
Phone
(530) 295-8000
Fax
(530) 295-9072
NPI assigned
Apr 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Debra Kidder
Title
Manager
Phone
(530) 295-8000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 54818 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 62434 CA

Addresses

Primary practice location

699 Main St
Suit B
Placerville, CA 95667-5760

Mailing address

699 Main St
Suit B
Placerville, CA 95667-5760
Phone (530) 295-8000

Other names 1

  • Placerville Dentistry Group Doing business as

National Provider Directory

National Provider Directory

Locations

699 Main St
Ste B
Placerville, CA 95667
Phone (530) 295-8000

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": "1397692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397692800000",
    "number": "1366862302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 MAIN ST",
            "address_2": "SUIT B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675760",
            "telephone_number": "530-295-8000",
            "fax_number": "530-295-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 MAIN ST",
            "address_2": "SUIT B",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675760",
            "telephone_number": "530-295-8000",
            "fax_number": "530-295-9072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEELE PLACERVILLE DENTAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-17",
        "last_updated": "2014-04-17",
        "status": "A",
        "authorized_official_last_name": "KIDDER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "530-295-8000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54818",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62434",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Placerville Dentistry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placerville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.