On-Site Dental Care Foundation, Inc

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

Legal business name

ON-SITE DENTAL CARE FOUNDATION, INC

Practice address

3180 Newberry Dr Ste 200
San Jose, CA 95118-1566

Phone

(408) 315-4864

Fax

(408) 608-2205

NPI assigned

Apr 18, 2018

Organization subpart

No

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

Authorized official

Name

Cheryl Martine Walter

Title

Executive Director

Phone

(408) 315-4864

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1629565338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41111",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951601111",
            "telephone_number": "408-315-4864",
            "fax_number": "408-608-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 NEWBERRY DR STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951181566",
            "telephone_number": "408-315-4864",
            "fax_number": "408-608-2205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Moorpark Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951282631",
            "country_code": "US",
            "telephone_number": "408-315-4864",
            "fax_number": "408-608-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ON-SITE DENTAL CARE FOUNDATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "MARTINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "408-315-4864"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "126800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• Public Health Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.