NPIMap

Organization Active NPI

Community Dental Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Stockton, CA
National Provider Identifier
1427223544
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
G58822 Issued in CA
Legal business name
COMMUNITY DENTAL SURGERY CENTER
Practice address
1523 E March LN
Suite 100
Stockton, CA 95310-5600
Phone
(209) 602-0212
NPI assigned
Apr 29, 2008
Last updated
Apr 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Mr. Marcus S. Kasprzyk
Title
Administrator
Phone
(209) 602-0212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X G58822 CA Primary

Addresses

Primary practice location

1523 E March LN
Suite 100
Stockton, CA 95310-5600

Mailing address

1523 E March LN
Suite 100
Stockton, CA 95210-5600
Phone (209) 602-0201

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1427223544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1523 E MARCH LN",
            "address_2": "SUITE 100",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952105600",
            "telephone_number": "209-602-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1523 E MARCH LN",
            "address_2": "SUITE 100",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "953105600",
            "telephone_number": "209-602-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "KASPRZYK",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-602-0212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G58822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.