Organization Active NPI

Parkside Dental Care

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fairfield, CA
National Provider Identifier
1720133796
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
45580 Issued in CA
Legal business name
PARKSIDE DENTAL CARE
Practice address
1325 Travis Blvd
Fairfield, CA 94533-4611
Phone
(707) 427-2222
Fax
(707) 427-0562
NPI assigned
Jan 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mrs. Avril May Altman
Title
Insurance Coordinator
Phone
(707) 427-2222

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 48710 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 28479 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 27964 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 30117 CA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 51677 CA
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 49443 CA
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 19300 CA
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 45580 CA Primary

Addresses

Primary practice location

1325 Travis Blvd
Fairfield, CA 94533-4611

Mailing address

1325 Travis Blvd
Fairfield, CA 94533-4611
Phone (707) 427-2222

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1720133796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 TRAVIS BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334611",
            "telephone_number": "707-427-2222",
            "fax_number": "707-427-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRAVIS BLVD",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334611",
            "telephone_number": "707-427-2222",
            "fax_number": "707-427-0562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKSIDE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "ALTMAN",
        "authorized_official_first_name": "AVRIL",
        "authorized_official_middle_name": "MAY",
        "authorized_official_title_or_position": "INSURANCE COORDINATOR",
        "authorized_official_telephone_number": "707-427-2222",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "48710",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28479",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27964",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30117",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "51677",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "49443",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "19300",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "45580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.