NPIMap

Organization Active NPI

Fore Dental a Professional Corporation

  • Dentist
  • Grass Valley, CA
National Provider Identifier
1427485259
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40589 Issued in CA
Legal business name
FORE DENTAL A PROFESSIONAL CORPORATION
Practice address
463 Sutton Way
Grass Valley, CA 95945-4102
Phone
(530) 273-1470
Fax
(530) 272-5409
NPI assigned
Oct 11, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Authorized official

Name
Dr. Stacy Fore, DDSNPI 1912087503
Title
Owner
Phone
(530) 273-1470

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 40589 CA Primary
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

463 Sutton Way
Grass Valley, CA 95945-4102

Mailing address

463 Sutton Way
Grass Valley, CA 95945-4102
Phone (530) 273-1470

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1381449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1427485259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-273-1470",
            "fax_number": "530-272-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 SUTTON WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959454102",
            "telephone_number": "530-273-1470",
            "fax_number": "530-272-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORE DENTAL A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-11",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "FORE",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-273-1470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40589",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.