Salida Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

53724 Issued in CA

Legal business name

SALIDA DENTAL GROUP

Practice address

5708 Pirrone Rd
Salida, CA 95368-9313

Phone

(209) 543-3888

NPI assigned

Feb 12, 2009

Organization subpart

No

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

Authorized official

Name

Dr. David S Park, DDS

Title

Dentist

Phone

(310) 403-1117

Specialties & licenses 1

Addresses

Tax ID family

Coffee Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• D Park DDS Inc

  • Dentist
  • Modesto, CA
  • NPI 1174869796
  NPD tax ID

Locations

Practitioners 2

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

• Clara Anisel Mendez Baez, DDS

  • Dentist
  • Salida, CA
  • NPI 1003283581
  NPD (past)
• Lora C. Ota, D.D.S.

  • General Practice Dentistry
  • Salida, CA
  • NPI 1992959332
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1407095599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5708 PIRRONE RD",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "953689313",
            "telephone_number": "209-543-3888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5708 PIRRONE RD",
            "city": "SALIDA",
            "state": "CA",
            "postal_code": "953689313",
            "telephone_number": "209-543-3888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALIDA DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "310-403-1117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma G Reif, RBT
• Glenn Scott Adriano Roldan
• Deziree Romero Torres, N/A
• Kaycera Jami Rushing
• Ellion Salazar, BCBA
• Salida Union Elementary School District
• Pedro Sepulveda IV
• Seva Hospice Inc
• Krupa S Sharma, MD
• Sipnk Admin LLC

• All providers in Salida, CA
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.