NPIMap

Organization Active NPI

S.Y. Jang DDS Corporatiom

  • Pediatric Dentistry
  • Elk Grove, CA
National Provider Identifier
1831589530
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
57611 Issued in CA
Legal business name
S.Y. JANG DDS CORPORATIOM
Practice address
9585 Laguna Springs Dr
# 120
Elk Grove, CA 95758-7969
Phone
(916) 271-3737
Fax
(916) 983-9012
NPI assigned
Feb 2, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Megan Poole
Title
Operations Manager
Phone
(916) 781-6550

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 57611 CA Primary

Addresses

Primary practice location

9585 Laguna Springs Dr
# 120
Elk Grove, CA 95758-7969

Mailing address

2260 E Bidwell St
# 316
Folsom, CA 95630-3463
Phone (916) 781-6550

Other names 1

  • Make A Smile Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Make a Smile7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

2260 E Bidwell St
#316
Folsom, CA 95630

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1831589530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 E BIDWELL ST",
            "address_2": "# 316",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303463",
            "telephone_number": "916-781-6550",
            "fax_number": "916-983-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9585 LAGUNA SPRINGS DR",
            "address_2": "# 120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587969",
            "telephone_number": "916-271-3737",
            "fax_number": "916-983-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S.Y. JANG DDS CORPORATIOM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "POOLE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "916-781-6550"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "57611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Make A Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.