Turlock Oral and Maxillofacial Sugery

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

53549 Issued in CA

Legal business name

TURLOCK ORAL AND MAXILLOFACIAL SUGERY

Practice address

1810 N Olive Ave Ste 8
Turlock, CA 95382-2500

Phone

(209) 667-5050

Fax

(209) 667-7559

NPI assigned

Aug 12, 2008

Last updated

Aug 12, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Victor T Pak, DDSNPI 1912950080

Title

Owner

Phone

(209) 667-5050

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor T Pak

  • Oral and Maxillofacial Surgery (Dentist)
  • Turlock, CA
  • NPI 1912950080
  Authorized official Same address or phone
• Alan John Vallarine, DDS

  • Dentist
  • Turlock, CA
  • NPI 1801983440
  NPD (past)

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218499200000",
    "number": "1487800215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 N OLIVE AVE STE 8",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822500",
            "telephone_number": "209-667-5050",
            "fax_number": "209-667-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 N OLIVE AVE STE 8",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822500",
            "telephone_number": "209-667-5050",
            "fax_number": "209-667-7559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TURLOCK ORAL AND MAXILLOFACIAL SUGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2008-08-12",
        "status": "A",
        "authorized_official_last_name": "PAK",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-667-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "53549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Turlock, CA
• Providers in Turlock, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.