Andrea Marie Pezoldt, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43072 Issued in CA

Practice address

200 C St
Patterson, CA 95363-2701

Phone

(209) 892-6307

Fax

(209) 892-2633

NPI assigned

Nov 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Andrea Marie Scroggin Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Golden Valley Health Centers

  • Federally Qualified Health Center (FQHC)
  • Turlock, CA
  • NPI 1356445753
  Medicare reassignment NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Planada, CA
  • NPI 1235114745
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1346224417
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Le Grand, CA
  • NPI 1356325310
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Merced, CA
  • NPI 1508333253
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Modesto, CA
  • NPI 1518298306
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Merced, CA
  • NPI 1528042512
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Newman, CA
  • NPI 1689658668
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Los Banos, CA
  • NPI 1730163734
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Dos Palos, CA
  • NPI 1770567778
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Westley, CA
  • NPI 1770568347
  NPD
• Golden Valley Health Center

  • Federally Qualified Health Center (FQHC)
  • Patterson, CA
  • NPI 1922082007
  NPD

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1447339353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 WEST CHILDS AVENUE",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953406805",
            "telephone_number": "209-383-1848",
            "fax_number": "209-384-3966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 C ST",
            "city": "PATTERSON",
            "state": "CA",
            "postal_code": "953632701",
            "telephone_number": "209-892-6307",
            "fax_number": "209-892-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEZOLDT",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "43072",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SCROGGIN",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Patterson Urgent Care
• Patterson Urgent Care Inc
• Dalila Perez-Deniz, DDS
• Denise Aldiany Perez
• Marion E. Perry-Dix, OTR/L/SWC
• Renee M. Pimentel, NP
• Leonard Piotrzkowski
• Steven M Pittson, D.C.
• Kiana Presley
• Alejandra Prieto de Chavez, FNP-C

• General Practice Dentistry in Patterson, CA
• Providers in Patterson, 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 Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.