NPIMap

Organization Active NPI

RC Dental Practice

  • General Practice Dentistry
  • Rancho Cordova, CA
National Provider Identifier
1851421416
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36317 Issued in CA
Legal business name
RC DENTAL PRACTICE
Practice address
10390 Coloma Road
#A
Rancho Cordova, CA 95670
Phone
(916) 368-0440
Fax
(916) 368-1111
NPI assigned
Mar 6, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Zsolt Kissevich
Title
Owner
Phone
(916) 368-0440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 36317 CA Primary

Addresses

Primary practice location

10390 Coloma Road
#A
Rancho Cordova, CA 95670

Mailing address

10390 Coloma Road
#A
Rancho Cordova, CA 95670
Phone (916) 368-0440

Other identifiers 1

IdentifierTypeStateIssuer
G9287201MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1851421416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10390 COLOMA ROAD",
            "address_2": "#A",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "916-368-0440",
            "fax_number": "916-368-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10390 COLOMA ROAD",
            "address_2": "#A",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "95670",
            "telephone_number": "916-368-0440",
            "fax_number": "916-368-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RC DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KISSEVICH",
        "authorized_official_first_name": "ZSOLT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-368-0440",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9287201",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.