NPIMap

Organization Active NPI

Northstate Dental

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1619758091
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHSTATE DENTAL
Practice address
2400 Maritime Drive
Elk Grove, CA 95758
Phone
(916) 686-8914
NPI assigned
Oct 11, 2023
Last updated
Oct 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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

Authorized official

Name
Dr. Alvin Cheung, PHARMD
Title
President/Ceo
Phone
(916) 216-6202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2400 Maritime Drive
Elk Grove, CA 95758

Mailing address

9700 W Taron Drive
Elk Grove, CA 95757
Phone (916) 686-7300

National Provider Directory

National Provider Directory
Tax ID family
Northstate Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1696982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1619758091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 W TARON DRIVE",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95757",
            "telephone_number": "916-686-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 MARITIME DRIVE",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95758",
            "telephone_number": "916-686-8914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSTATE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-11",
        "last_updated": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "CHEUNG",
        "authorized_official_first_name": "ALVIN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "916-216-6202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.