NPIMap

Organization Active NPI

Maria Teresa R de Guzman DDS Corp

  • Dentist
  • Roseville, CA
National Provider Identifier
1487031027
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41390 Issued in CA
Legal business name
MARIA TERESA R DE GUZMAN DDS CORP
Practice address
2436 Professional Dr
Suite 200
Roseville, CA 95661-7779
Phone
(916) 774-9920
Fax
(916) 910-0752
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Anthony Escano Deguzman Sr.
Title
Administartor
Phone
(916) 919-5721

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 41390 CA Primary
Preferred Provider Organization 305R00000X 41390 CA

Addresses

Primary practice location

2436 Professional Dr
Suite 200
Roseville, CA 95661-7779

Mailing address

5060 Sunrise Blvd
Suite A3
Fair Oaks, CA 95628-4944
Phone (916) 919-5721

Other names 1

  • MyToothSpa Dentistry and Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maria Teresa R de Guzman DDS Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

5060 Sunrise Blvd
Ste A3
Fair Oaks, CA 95628

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": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1487031027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SUNRISE BLVD",
            "address_2": "SUITE A3",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284944",
            "telephone_number": "916-919-5721",
            "fax_number": "916-910-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2436 PROFESSIONAL DR",
            "address_2": "SUITE 200",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956617779",
            "telephone_number": "916-774-9920",
            "fax_number": "916-910-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA TERESA R DE GUZMAN DDS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "DEGUZMAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ESCANO",
        "authorized_official_title_or_position": "ADMINISTARTOR",
        "authorized_official_telephone_number": "916-919-5721",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41390",
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "41390",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyToothSpa Dentistry and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.