NPIMap

Organization Active NPI

C-Dental X-Ray, Inc.

  • Dental Laboratory
  • Menlo Park, CA
National Provider Identifier
1639555105
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
License
RHP00053519 Issued in CA
Legal business name
C-DENTAL X-RAY, INC.
Practice address
695 Oak Grove Ave
Ste. 330
Menlo Park, CA 94025-4351
Phone
(652) 323-0204
NPI assigned
Aug 6, 2015
Last updated
Aug 6, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Authorized official

Name
Mr. Jerome N Peck, DLXT
Title
Ceo
Phone
(650) 207-6209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X RHP00053519 CA Primary

Addresses

Primary practice location

695 Oak Grove Ave
Ste. 330
Menlo Park, CA 94025-4351

Mailing address

450 Sutter St
Ste. 1542
San Francisco, CA 94108-4206
Phone (415) 421-1389

National Provider Directory

National Provider Directory
Tax ID family
C-Dental X-Ray Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

695 Oak Grove Ave
Ste 330
Menlo Park, CA 94025
Phone (652) 323-0204

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1639555105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "STE. 1542",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-421-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 OAK GROVE AVE",
            "address_2": "STE. 330",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254351",
            "telephone_number": "652-323-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C-DENTAL X-RAY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "650-207-6209",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DLXT"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "CA",
            "license": "RHP00053519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menlo Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2015; 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.