Mission Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MISSION DENTAL

Practice address

1166 Broadway Ste J
Placerville, CA 95667-5754

Phone

(530) 626-8626

NPI assigned

Mar 2, 2015

Organization subpart

No

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

Authorized official

Name

Ms. Julie Ann Day

Title

Executive Director

Phone

(916) 837-7174

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438819200000",
    "number": "1689066516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1043",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956671043",
            "telephone_number": "530-626-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1166 BROADWAY STE J",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675754",
            "telephone_number": "530-626-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-02",
        "last_updated": "2015-08-06",
        "status": "A",
        "authorized_official_last_name": "DAY",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "916-837-7174",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Miner, CADC II
• Minh-Khang Eric Ngo Dental Corporation
• Angela Minor
• Danielle Miranda
• Stephanie Mirando, PHARM.D
• Jay Edward Mitchell-Wright
• Catherine Elizabeth Moizeau, MD
• Christopher J Molitor, M.D.
• Maria Anna Momsen
• Amy Kristine Mondani, AU.D.

• General Practice Dentistry in Placerville, CA
• Providers in Placerville, CA by specialty
• General Practice Dentistry in California

• 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.