NPIMap

Organization Active NPI

Sireesha Penumetcha, DDS PC

  • Dental Clinic/Center
  • Elk Grove, CA
National Provider Identifier
1861118580
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
SIREESHA PENUMETCHA, DDS PC
Doing business as
Lakepoint Dental
Practice address
4720 Elk Grove Blvd Ste 170
Elk Grove, CA 95758-4185
Phone
(916) 691-9191
NPI assigned
Oct 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Authorized official

Name
Dr. Sireesha PenumetchaNPI 1154368967
Title
President
Phone
(916) 691-9191

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

4720 Elk Grove Blvd Ste 170
Elk Grove, CA 95758-4185

Mailing address

4720 Elk Grove Blvd Ste 170
Elk Grove, CA 95758-4185
Phone (916) 691-9191

Other names 1

  • Lakepoint Dental Doing business as

National Provider Directory

National Provider Directory

Locations

4720 Elk Grove Blvd
Ste 170
Elk Grove, CA 95758
Phone (916) 691-9191

Practitioners & affiliated clinicians

Practitioners 3

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": "1665705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665705600000",
    "number": "1861118580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 ELK GROVE BLVD STE 170",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584185",
            "telephone_number": "916-691-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 ELK GROVE BLVD STE 170",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584185",
            "telephone_number": "916-691-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIREESHA PENUMETCHA, DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "PENUMETCHA",
        "authorized_official_first_name": "SIREESHA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-691-9191",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakepoint Dental",
            "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 Oct 14, 2022; 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.