Organization Active NPI

San Pablo Dental Management Inc

  • Dental Clinic/Center
  • El Cerrito, CA
National Provider Identifier
1861082836
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SAN PABLO DENTAL MANAGEMENT INC
Practice address
11100 San Pablo Ave
El Cerrito, CA 94530-2194
Phone
(510) 233-9022
NPI assigned
Jan 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Authorized official

Name
Jeremie Respicio
Title
Manager
Phone
(415) 301-9450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

11100 San Pablo Ave
El Cerrito, CA 94530-2194

Mailing address

11100 San Pablo Ave
El Cerrito, CA 94530-2194
Phone (510) 233-9022

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL dcmdental@yahooo.com Health Information Exchange (HIE)

National Provider Directory

National Provider Directory

Locations

11100 San Pablo Ave
El Cerrito, CA 94530
Phone (510) 233-9022

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": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1861082836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 SAN PABLO AVE",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945302194",
            "telephone_number": "510-233-9022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 SAN PABLO AVE",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945302194",
            "telephone_number": "510-233-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN PABLO DENTAL MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "RESPICIO",
        "authorized_official_first_name": "JEREMIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "415-301-9450"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "dcmdental@yahooo.com",
            "affiliation": "N",
            "endpointDescription": "company email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11100 San Pablo Ave",
            "city": "El Cerrito",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945302194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in El Cerrito, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.