NPIMap

Organization Active NPI

Ponce de Leon Dental

  • Dentist
  • Sacramento, CA
National Provider Identifier
1851693295
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40875 Issued in CA
Legal business name
PONCE DE LEON DENTAL
Practice address
1589 W. El Camino Ave.
Ste. 108
Sacramento, CA 95833
Phone
(916) 564-2020
Fax
(916) 564-3900
NPI assigned
Nov 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

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

Authorized official

Name
Dr. Alberto Ponce de Leon, D.M.D.
Title
Dentist/Co-Owner
Phone
(916) 564-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 40875 CA Primary

Addresses

Primary practice location

1589 W. El Camino Ave.
Ste. 108
Sacramento, CA 95833

Mailing address

1589 W. El Camino Ave
Suite 108
Sacramento, CA 95833
Phone (916) 564-2020

National Provider Directory

National Provider Directory

Locations

1589 W El Camino Ave
Ste 108
Sacramento, CA 95833
Phone (916) 564-2020

Practitioners & affiliated clinicians

Practitioners 1

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": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289952000000",
    "number": "1851693295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 W. EL CAMINO AVE",
            "address_2": "SUITE 108",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95833",
            "telephone_number": "916-564-2020",
            "fax_number": "916-564-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1589 W. EL CAMINO AVE.",
            "address_2": "STE. 108",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95833",
            "telephone_number": "916-564-2020",
            "fax_number": "916-564-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONCE DE LEON DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2010-11-17",
        "status": "A",
        "authorized_official_last_name": "PONCE DE LEON",
        "authorized_official_first_name": "ALBERTO",
        "authorized_official_title_or_position": "DENTIST/CO-OWNER",
        "authorized_official_telephone_number": "916-564-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 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.