NPIMap

Organization Active NPI

Paul V Sejud DMD PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Rosa, CA
National Provider Identifier
1427138684
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
33888 Issued in CA
Legal business name
PAUL V SEJUD DMD PC
Practice address
1111 Sonoma Ave
#220
Santa Rosa, CA 95405
Phone
(707) 566-7300
Fax
(707) 566-7400
NPI assigned
Oct 16, 2006
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
Paul V Sejud, DMDNPI 1881779387
Title
President
Phone
(707) 566-7300

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
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 33888 CA Primary

Addresses

Primary practice location

1111 Sonoma Ave
#220
Santa Rosa, CA 95405

Mailing address

1111 Sonoma Ave
#220
Santa Rosa, CA 95405
Phone (707) 566-7300

National Provider Directory

National Provider Directory

Locations

1111 Sonoma Ave
Ste 220
Santa Rosa, CA 95405
Phone (707) 566-7300

Practitioners & affiliated clinicians

Practitioners 3

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": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427138684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "#220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-566-7300",
            "fax_number": "707-566-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SONOMA AVE",
            "address_2": "#220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-566-7300",
            "fax_number": "707-566-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL V SEJUD DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SEJUD",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-566-7300",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "33888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, 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.