Summit Dental Practice

Primary specialty

DentistTaxonomy code 122300000X

License

39990 Issued in CA

Legal business name

SUMMIT DENTAL PRACTICE

Practice address

25004 Blue Ravine Rd
Folsom, CA 95630-5283

Phone

(916) 355-8400

Fax

(916) 355-8460

NPI assigned

Mar 18, 2015

Organization subpart

No

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

Authorized official

Name

Mahnaz Moussavi

Title

DDS

Phone

(916) 355-8400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1578956363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25004 BLUE RAVINE RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305283",
            "telephone_number": "916-355-8400",
            "fax_number": "916-355-8460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25004 BLUE RAVINE RD",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956305283",
            "telephone_number": "916-355-8400",
            "fax_number": "916-355-8460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "MOUSSAVI",
        "authorized_official_first_name": "MAHNAZ",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "916-355-8400"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "39990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sue & Yee Dental, a General Partnership
• Noor Sulaiman
• Laura Lynn Sullivan, MFT
• Viki Catherine Sullivan, F.N.P
• Kenneth T. Sumida, MD
• Summit Naturopathic Inc.
• Summit Oaks Home Health Services LLC
• Henry William Sundermier, M.D.
• Shannon T Suo, M.D.
• Kristia Ann Suutala, PT

• Dentist in Folsom, CA
• Providers in Folsom, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.