NPIMap

Organization Active NPI

Fouladi Professional Dental Corp.

  • Oral and Maxillofacial Surgery (Dentist)
  • Sacramento, CA
National Provider Identifier
1669114898
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
FOULADI PROFESSIONAL DENTAL CORP.
Doing business as
Sacramento Oral Surgery South
Practice address
7551 Timberlake Way Ste 120
Sacramento, CA 95823-5421
Phone
(916) 423-4092
Fax
(916) 423-3125
NPI assigned
Apr 8, 2022
Organization subpart
Yes
Parent organization
FOULADI PROFESSIONAL DENTAL CORP.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

7551 Timberlake Way Ste 120
Sacramento, CA 95823-5421

Mailing address

7551 Timberlake Way Ste 120
Sacramento, CA 95823-5421
Phone (916) 423-4092

Other names 1

  • Sacramento Oral Surgery South Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fouladi Professional Dental Corp4 organizations share this tax ID, including this one
Part of
Fouladi Professional Dental Corp

Other organizations with this tax ID 3

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

Locations

7551 Timberlake Way
Ste 120
Sacramento, CA 95823
Phone (916) 423-4092

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": "1649376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649376000000",
    "number": "1669114898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7551 TIMBERLAKE WAY STE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235421",
            "telephone_number": "916-423-4092",
            "fax_number": "916-423-3125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7551 TIMBERLAKE WAY STE 120",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235421",
            "telephone_number": "916-423-4092",
            "fax_number": "916-423-3125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOULADI PROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOULADI PROFESSIONAL DENTAL CORP.",
        "enumeration_date": "2022-04-08",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sacramento Oral Surgery South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.