NPIMap

Organization Active NPI

Creative Dimensions in Dentistry

  • Dentist
  • Castro Valley, CA
National Provider Identifier
1396957866
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CREATIVE DIMENSIONS IN DENTISTRY
Practice address
20265 Lake Chabot Rd
Castro Valley, CA 94546-5307
Phone
(510) 881-8010
Fax
(510) 538-0120
NPI assigned
May 4, 2007
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. George David Mackenzie, DDSNPI 1114070315
Title
Manager
Phone
(510) 881-8010

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X CA Primary

Addresses

Primary practice location

20265 Lake Chabot Rd
Castro Valley, CA 94546-5307

Mailing address

20265 Lake Chabot Rd
Castro Valley, CA 94546-5307
Phone (510) 881-8010

National Provider Directory

National Provider Directory

Locations

20265 Lake Chabot Rd
Castro Valley, CA 94546
Phone (510) 537-3050

Practitioners & affiliated clinicians

Practitioners 6

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": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396957866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20265 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465307",
            "telephone_number": "510-881-8010",
            "fax_number": "510-538-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20265 LAKE CHABOT RD",
            "city": "CASTRO VALLEY",
            "state": "CA",
            "postal_code": "945465307",
            "telephone_number": "510-881-8010",
            "fax_number": "510-538-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREATIVE DIMENSIONS IN DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKENZIE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "510-881-8010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Castro Valley, 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.