SCDP Eastlake, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

SCDP EASTLAKE, LLC

Doing business as

Macatangay Dentistry

Practice address

890 Eastlake Pkwy Ste 201
Chula Vista, CA 91914-4521

Phone

(619) 421-2828

NPI assigned

May 12, 2021

Organization subpart

Yes

Parent organization

SILVER CREEK DENTAL PARTNERS, LLCAs reported in NPPES

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

Authorized official

Name

Brad Starkweather

Title

Manager

Phone

(650) 922-0897

Specialties & licenses 1

Addresses

Other names 1

• Macatangay Dentistry Doing business as

Part of

Silver Creek Dental Partners

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Silver Creek Dental Partners

  • Dental Clinic/Center
  • Chula Vista, CA
  • NPI 1194572198
  NPPES parent name

Practitioners 2

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

• Allie Nicole Long, DDS

  • General Practice Dentistry
  • Chula Vista, CA
  • NPI 1659864023
  NPD
• Cecile C Macatangay, DMD

  • General Practice Dentistry
  • Chula Vista, CA
  • NPI 1679737704
  NPD (past)

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

{
    "created_epoch": "1620777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620777600000",
    "number": "1407430630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23911 DANZIG BAY",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926294407",
            "telephone_number": "650-922-0897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PKWY STE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919144521",
            "telephone_number": "619-421-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCDP EASTLAKE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SILVER CREEK DENTAL PARTNERS, LLC",
        "enumeration_date": "2021-05-12",
        "last_updated": "2021-05-12",
        "certification_date": "2021-05-12",
        "status": "A",
        "authorized_official_last_name": "STARKWEATHER",
        "authorized_official_first_name": "BRAD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "650-922-0897"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macatangay Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sbrrc
• SC Assisted Living 4 Inc
• Mya Scales
• Myriam Lourdes Scales, CADC I
• Breanne Scalise, LCSW
• Gina Q Schaan
• Samantha Lee Schaeffer
• Stuart Schafer, MD
• Paul Schalch, MD
• Julie Schanze, LCSW

• General Practice Dentistry in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2021; 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.