NPIMap

Organization Active NPI

Elsemary and Salem Dental Corporation

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1679911473
Registry record updated Jun 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50364 Issued in CA
Legal business name
ELSEMARY AND SALEM DENTAL CORPORATION
Practice address
9045 Bruceville Rd
Suite #160
Elk Grove, CA 95758-5948
Phone
(916) 683-3841
Fax
(916) 683-3848
NPI assigned
Jun 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2013

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

Authorized official

Name
Veronica Cortes
Title
Office Manager
Phone
(916) 683-3841

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 50364 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 47882 CA

Addresses

Primary practice location

9045 Bruceville Rd
Suite #160
Elk Grove, CA 95758-5948

Mailing address

9045 Bruceville Rd
Suite #160
Elk Grove, CA 95758-5948
Phone (916) 683-3841

Other names 1

  • Wackford Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Elsemary and Salem Dental Corporation3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

9045 Bruceville Rd
Ste 160
Elk Grove, CA 95758
Phone (916) 683-3841

Practitioners & affiliated clinicians

Practitioners 1

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": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1679911473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "address_2": "SUITE #160",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-683-3841",
            "fax_number": "916-683-3848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9045 BRUCEVILLE RD",
            "address_2": "SUITE #160",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957585948",
            "telephone_number": "916-683-3841",
            "fax_number": "916-683-3848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELSEMARY AND SALEM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "CORTES",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "916-683-3841"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50364",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47882",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wackford Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.