NPIMap

Organization Active NPI

C-Dental X-Ray, Inc.

  • Dental Laboratory
  • San Rafael, CA
National Provider Identifier
1609242205
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
License
RHP00053519 Issued in CA
Legal business name
C-DENTAL X-RAY, INC.
Practice address
1050 Northgate Dr
Ste. 110
San Rafael, CA 94903-2526
Phone
(415) 472-1323
NPI assigned
Aug 18, 2015
Last updated
Aug 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Authorized official

Name
Mr. Jerome N Peck, DLXT
Title
Ceo
Phone
(650) 207-6209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X RHP00053519 CA Primary

Addresses

Primary practice location

1050 Northgate Dr
Ste. 110
San Rafael, CA 94903-2526

Mailing address

450 Sutter St
Ste. 1542
San Francisco, CA 94108-4206
Phone (415) 421-1389

National Provider Directory

National Provider Directory
Tax ID family
C-Dental X-Ray Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

1050 Northgate Dr
Ste 110
San Rafael, CA 94903
Phone (415) 472-1323

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439856000000",
    "number": "1609242205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "STE. 1542",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-421-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NORTHGATE DR",
            "address_2": "STE. 110",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032526",
            "telephone_number": "415-472-1323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C-DENTAL X-RAY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-207-6209",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DLXT"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "CA",
            "license": "RHP00053519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

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