North Valley Dental

Primary specialty

DentistTaxonomy code 122300000X

License

31510 Issued in CA

Legal business name

NORTH VALLEY DENTAL

Practice address

770 Mason St Ste 110
Vacaville, CA 95688-4648

Phone

(707) 447-1010

NPI assigned

Nov 2, 2016

Organization subpart

No

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

Authorized official

Name

Wayne N Pedersen, D.D.S.NPI 1700983780

Title

Owner

Phone

(707) 447-1010

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wayne N Pedersen, DDS

  • General Practice Dentistry
  • Vacaville, CA
  • NPI 1700983780
  NPD (past) Authorized official
• Jeffrey Youngberg

  • Dentist
  • Vacaville, CA
  • NPI 1003292608
  NPD (past)

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

{
    "created_epoch": "1478044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478044800000",
    "number": "1730631086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 MASON ST STE 110",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884648",
            "telephone_number": "707-447-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 MASON ST STE 110",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "956884648",
            "telephone_number": "707-447-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-02",
        "last_updated": "2016-11-02",
        "status": "A",
        "authorized_official_last_name": "PEDERSEN",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-447-1010",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "31510",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "64725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alfredo Quicho Noriega, M.D.
• Heidi Aldea Noriesta, LVN
• Elvin L Norman, PHARM D
• Ryan Norris
• North Bay Prosthetics and Orthotics LLC
• Northbay Healthcare Group
• Northbay Healthcare Group (Northbay VacaValley Hospital)
• Northbay Healthcare Group (Northbay Specialty Pharmacy)
• Northbay Healthcare Group (NorthBay VacaValley Hospital)
• Northbay Physicians Surgery Center LLC (The Surgery Center)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.