Park Plaza Dental

Primary specialty

DentistTaxonomy code 122300000X

License

62200 Issued in CA

Legal business name

PARK PLAZA DENTAL

Practice address

245 Kentucky St Ste E
Petaluma, CA 94952-2877

Phone

(707) 763-4142

NPI assigned

Oct 27, 2014

Organization subpart

No

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

Authorized official

Name

Mona Mahmoodi

Title

DDS

Phone

(310) 993-5758

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414368000000",
    "number": "1720483225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 KENTUCKY ST STE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522877",
            "telephone_number": "707-763-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 KENTUCKY ST STE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522877",
            "telephone_number": "707-763-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLAZA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-10-27",
        "status": "A",
        "authorized_official_last_name": "MAHMOODI",
        "authorized_official_first_name": "MONA",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "310-993-5758"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "62200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blanca E Pantaleon
• Jessica Rocio Pantoja-Alvarado
• Chitra Parameshwaran, CCC-SLP/L
• Vanessa Elisa Paravati
• Parinaz Azari MD Inc
• Joseph Park, L.AC.
• Erneshia Parker, BA PSYCHOLOGY
• Judith Kay Parker, DC
• Kathleen Parker
• Peggy Anne Parnell, MFT INTERN

• Dentist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2014; 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.