NPIMap

Organization Active NPI

Paolo a Poidmore, DDS, MSD, a Professional Dental Corporation

Doing business as Poidmore Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Orangevale, CA
National Provider Identifier
1639537863
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
58354 Issued in CA
Legal business name
PAOLO A POIDMORE, DDS, MSD, A PROFESSIONAL DENTAL CORPORATION
Doing business as
Poidmore Orthodontics
Practice address
9197 Greenback LN Ste B
Orangevale, CA 95662-4792
Phone
(916) 989-2187
Fax
(916) 989-2187
NPI assigned
Feb 2, 2016
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Paolo A Poidmore, DDS, MSDNPI 1285862904
Title
Owner
Phone
(916) 259-9255

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 58354 CA Primary

Addresses

Primary practice location

9197 Greenback LN Ste B
Orangevale, CA 95662-4792

Mailing address

3075 Beacon Blvd
West Sacramento, CA 95691-3462
Phone (916) 259-9255

Other names 1

  • Poidmore Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Paolo a Poidmore DDS MSD a Professional Dental Corporation2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1639537863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-259-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9197 GREENBACK LN STE B",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956624792",
            "telephone_number": "916-989-2187",
            "fax_number": "916-989-2187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAOLO A POIDMORE, DDS, MSD, A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "POIDMORE",
        "authorized_official_first_name": "PAOLO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-259-9255",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "58354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poidmore Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 13, 2024; 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.