NPIMap

Organization Active NPI

Newsom Forester Dental Partnership

Doing business as Coastal Pediatric Dentistry

  • Pediatric Dentistry
  • San Luis Obispo, CA
National Provider Identifier
1790127173
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
50253 Issued in CA
Legal business name
NEWSOM FORESTER DENTAL PARTNERSHIP
Doing business as
Coastal Pediatric Dentistry
Practice address
620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541
Phone
(805) 592-2020
Fax
(805) 592-2022
NPI assigned
Jul 25, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Authorized official

Name
Dr. James Alexander Forester, DDSNPI 1013075159
Title
Co-Owner/Partner
Phone
(805) 592-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 50253 CA Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 55823 CA

Addresses

Primary practice location

620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541

Mailing address

620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541
Phone (805) 592-2020

Other names 1

  • Coastal Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

620 California Blvd
Ste G
Sn Luis Obisp, CA 93401
Phone (805) 543-7668

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374710400000",
    "number": "1790127173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD",
            "address_2": "SUITE G",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012541",
            "telephone_number": "805-592-2020",
            "fax_number": "805-592-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 CALIFORNIA BLVD",
            "address_2": "SUITE G",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012541",
            "telephone_number": "805-592-2020",
            "fax_number": "805-592-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWSOM FORESTER DENTAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2013-07-25",
        "status": "A",
        "authorized_official_last_name": "FORESTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "CO-OWNER/PARTNER",
        "authorized_official_telephone_number": "805-592-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "50253",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "55823",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.