NPIMap

Organization Active NPI

Golden State Smiles

  • Dentist
  • Concord, CA
National Provider Identifier
1649747577
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
GOLDEN STATE SMILES
Doing business as
Golden State Smiles
Practice address
1851 Sutter St
Concord, CA 94520-2559
Phone
(925) 827-2798
Fax
(916) 384-3844
NPI assigned
Oct 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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

Authorized official

Name
Dr. Yan Kalika, DDS
Title
Owner
Phone
(916) 702-1213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

1851 Sutter St
Concord, CA 94520-2559

Mailing address

3075 Beacon Blvd
W Sacramento, CA 95691-3462
Phone (916) 702-1213

Other names 1

  • Golden State Smiles Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Golden State Smiles2 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.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1649747577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "W SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-702-1213",
            "fax_number": "916-384-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 SUTTER ST",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202559",
            "telephone_number": "925-827-2798",
            "fax_number": "916-384-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE SMILES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "KALIKA",
        "authorized_official_first_name": "YAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-702-1213",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden State Smiles",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Golden State Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.