NPIMap

Organization Active NPI

Sierra Periodontal Group

  • Periodontics
  • Orangevale, CA
National Provider Identifier
1639492226
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
47415 Issued in CA
Legal business name
SIERRA PERIODONTAL GROUP
Practice address
8680 Greenback Lane Suite 109
Orangevale, CA 95662-7790
Phone
(916) 962-0545
Fax
(916) 962-0927
NPI assigned
Mar 10, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Authorized official

Name
Mrs. Elaheh Samsari, DDS
Title
Owner
Phone
(916) 962-0545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 47415 CA Primary

Addresses

Primary practice location

8680 Greenback Lane Suite 109
Orangevale, CA 95662-7790

Mailing address

8680 Greenback Lane Suite 109
Orangevale, CA 95662-7790
Phone (916) 962-0545

National Provider Directory

National Provider Directory

Locations

7916 Pebble Beach Dr
Ste 104
Citrus Heights, CA 95610
Phone (916) 962-0545

8680 Greenback Ln
Ste 109
Orangevale, CA 95662
Phone 9164194588 ext. 3

Practitioners & affiliated clinicians

Practitioners 3

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": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741305600000",
    "number": "1639492226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8680 GREENBACK LANE SUITE 109",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956627790",
            "telephone_number": "916-962-0545",
            "fax_number": "916-962-0927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8680 GREENBACK LANE SUITE 109",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956627790",
            "telephone_number": "916-962-0545",
            "fax_number": "916-962-0927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA PERIODONTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "SAMSARI",
        "authorized_official_first_name": "ELAHEH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-962-0545",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "47415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orangevale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2025; 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.