NPIMap

Organization Active NPI

Chico Periodontal Associates

  • Periodontics
  • Chico, CA
National Provider Identifier
1619179629
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
41959 Issued in CA
Legal business name
CHICO PERIODONTAL ASSOCIATES
Practice address
30 Declaration Dr
Chico, CA 95973-4911
Phone
(530) 898-1234
Fax
(530) 898-0725
NPI assigned
Jun 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Eleanor T Ward
Title
Office Manager
Phone
(530) 898-1234

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 35882 CA
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 41959 CA Primary

Addresses

Primary practice location

30 Declaration Dr
Chico, CA 95973-4911

Mailing address

30 Declaration Dr
Chico, CA 95973-4911
Phone (530) 898-1234

National Provider Directory

National Provider Directory

Locations

30 Declaration Dr
Chico, CA 95973
Phone (530) 898-1234

NPI Registry JSON

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619179629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 DECLARATION DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734911",
            "telephone_number": "530-898-1234",
            "fax_number": "530-898-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 DECLARATION DR",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734911",
            "telephone_number": "530-898-1234",
            "fax_number": "530-898-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICO PERIODONTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "ELEANOR",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "530-898-1234",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "35882",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "41959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.