Sonoma Dental Group, P.C.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2901017343 Issued in MI

Legal business name

SONOMA DENTAL GROUP, P.C.

Practice address

234 W Caroline St
Suite 5
Fenton, MI 48430-2807

Phone

(810) 629-7682

Fax

(810) 629-0158

NPI assigned

May 14, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Nahal Mazhari, DDSNPI 1144320961

Title

Secretary

Phone

(810) 629-7682

Specialties & licenses 1

Addresses

Tax ID family

Sonoma Dental Group PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sonoma Dental Group, P.C.

  • General Practice Dentistry
  • Fenton, MI
  • NPI 1225346968
  NPD tax ID

Locations

Practitioners 1

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

• Nahal Mazhari, DDS

  • General Practice Dentistry
  • Fenton, MI
  • NPI 1144320961
  NPD (past) Authorized official

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1447427885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 W CAROLINE ST",
            "address_2": "SUITE 5",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302807",
            "telephone_number": "810-629-7682",
            "fax_number": "810-629-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 W CAROLINE ST",
            "address_2": "SUITE 5",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484302807",
            "telephone_number": "810-629-7682",
            "fax_number": "810-629-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SONOMA DENTAL GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "MAZHARI",
        "authorized_official_first_name": "NAHAL",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "810-629-7682",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901017343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Noelle Smith
• Shelby Lynn Beckman Smith, LPC, NCC
• Colene A. Snowden, AFC PROVIDER
• McKenzie Sobczak, TLLP
• Sonoma Dental Group, P.C.
• Spark Speech Therapy LLC
• SSC Fenton Operating Company LLC
• Elizabeth Diane Stamp, LMSW
• Stephanie Stanton, OTR
• Tiffany Starr

• Dental Clinic/Center in Fenton, MI
• Providers in Fenton, MI by specialty
• Dental Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.