NPIMap

Organization Active NPI

Pleasant Valley Dental

  • Dentist
  • El Dorado, CA
National Provider Identifier
1790921989
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D43010 Issued in CA
Legal business name
PLEASANT VALLEY DENTAL
Doing business as
Pleasant Valley Dental, General Dental Practice of Mitchell A. Goodis,
Practice address
6400 Pleasant Valley Rd
El Dorado, CA 95623-4230
Phone
(530) 622-2862
Fax
(530) 622-2072
NPI assigned
Dec 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Authorized official

Name
Dr. Mitchell A Goodis, DDS
Title
Dentist
Phone
(530) 344-0290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D43010 CA Primary

Addresses

Primary practice location

6400 Pleasant Valley Rd
El Dorado, CA 95623-4230

Mailing address

PO Box 568
El Dorado, CA 95623-0568
Phone (530) 622-2862

Other identifiers 1

IdentifierTypeStateIssuer
1854195417OtherCANPI FROM PRIMARY OFFICE AT DIAMOND SPRINGS DENTAL CENTER

Other names 1

  • Pleasant Valley Dental, General Dental Practice of Mitchell A. Goodis, Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Diamond Springs Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285632000000",
    "number": "1790921989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "EL DORADO",
            "state": "CA",
            "postal_code": "956230568",
            "telephone_number": "530-622-2862",
            "fax_number": "530-622-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6400 PLEASANT VALLEY RD",
            "city": "EL DORADO",
            "state": "CA",
            "postal_code": "956234230",
            "telephone_number": "530-622-2862",
            "fax_number": "530-622-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLEASANT VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2010-09-28",
        "status": "A",
        "authorized_official_last_name": "GOODIS",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "530-344-0290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D43010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FROM PRIMARY OFFICE AT DIAMOND SPRINGS DENTAL CENTER",
            "identifier": "1854195417",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pleasant Valley Dental, General Dental Practice of Mitchell A. Goodis,",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in El Dorado, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2010; 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.