NPIMap

Organization Active NPI

Amezcua Dental Corporation

Doing business as Market West Dental Group

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1679666432
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
AMEZCUA DENTAL CORPORATION
Doing business as
Market West Dental Group
Practice address
3290 Arena Blvd
Ste. 610
Sacramento, CA 95834-3003
Phone
(916) 574-9400
Fax
(916) 574-9494
NPI assigned
Oct 2, 2006
Last updated
May 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Dr. Osvaldo Amezcua, DDS
Title
Owner DDS
Phone
(916) 574-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

3290 Arena Blvd
Ste. 610
Sacramento, CA 95834-3003

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 508-3600

Other names 1

  • MARKET WEST DENTAL GROUP Doing business as

National Provider Directory

National Provider Directory

Locations

3290 Arena Blvd
Ste 610
Sacramento, CA 95834
Phone (916) 574-9400

Practitioners & affiliated clinicians

Practitioners 11

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": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1679666432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-508-3600",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 ARENA BLVD",
            "address_2": "STE. 610",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958343003",
            "telephone_number": "916-574-9400",
            "fax_number": "916-574-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEZCUA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "AMEZCUA",
        "authorized_official_first_name": "OSVALDO",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "916-574-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARKET WEST DENTAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MARKET WEST DENTAL GROUP",
            "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 May 11, 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.