Alec Clark Nelson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32882 Issued in CA

Practice address

855 Fountain Grove Pkwy
Suite 100
Santa Rosa, CA 95403-5736

Phone

(707) 546-2829

Fax

(707) 546-2778

NPI assigned

Oct 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821178765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 FOUNTAIN GROVE PKWY",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035736",
            "telephone_number": "707-546-2829",
            "fax_number": "707-546-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 FOUNTAIN GROVE PKWY",
            "address_2": "SUITE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954035736",
            "telephone_number": "707-546-2829",
            "fax_number": "707-546-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "ALEC",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Vangundia Neel, MD
• Leandra Neely
• Kendra N Neese
• Amanda Negrete
• Roberto Neisa, M.D.
• Cavan Nelson, EMT
• Kevin M Nelson
• Mickie G Nelson, LCSW
• Patricia R Nelson
• Raquel Nelson, CMT

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.