Organization Active NPI

Simonne Pereira Patric DDS , Corporation

  • Dental Clinic/Center
  • Antelope, CA
National Provider Identifier
1629648803
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIMONNE PEREIRA PATRIC DDS , CORPORATION
Practice address
3535 Elverta Rd Ste E
Antelope, CA 95843-4721
Phone
(916) 692-8633
Fax
(916) 692-8638
NPI assigned
Jun 29, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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

Authorized official

Name
Simonne Pereira Patrick, DDS
Title
President
Phone
(916) 600-3221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

3535 Elverta Rd Ste E
Antelope, CA 95843-4721

Mailing address

3535 Elverta Rd Ste E
Antelope, CA 95843-4721
Phone (916) 692-8633

Other names 1

  • SMILE CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

3535 Elverta Rd
Ste E
Antelope, CA 95843
Phone (916) 349-9990

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624924800000",
    "number": "1629648803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 ELVERTA RD STE E",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958434721",
            "telephone_number": "916-692-8633",
            "fax_number": "916-692-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ELVERTA RD STE E",
            "city": "ANTELOPE",
            "state": "CA",
            "postal_code": "958434721",
            "telephone_number": "916-692-8633",
            "fax_number": "916-692-8638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONNE PEREIRA PATRIC DDS , CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-27",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "SIMONNE",
        "authorized_official_middle_name": "PEREIRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-600-3221",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMILE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Antelope, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.