NPIMap

Organization Active NPI

Powell Pediatric Dentistry Chestnut Partnership

  • Pediatric Dentistry
  • Fresno, CA
National Provider Identifier
1861979544
Registry record updated Jul 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
56148 Issued in CA
Legal business name
POWELL PEDIATRIC DENTISTRY CHESTNUT PARTNERSHIP
Practice address
7005 N. Chestnut Ave Ste 101
Fresno, CA 93720
Phone
(559) 299-5949
Fax
(559) 299-7880
NPI assigned
Jul 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2018

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

Authorized official

Name
Mr. Brent D Powell, DMD
Title
Managing Member
Phone
(559) 299-3949

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 56148 CA Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 101165 CA

Addresses

Primary practice location

7005 N. Chestnut Ave Ste 101
Fresno, CA 93720

Mailing address

7005 N. Chestnut Ave Ste. 101
Fresno, CA 93720
Phone (559) 299-5949

National Provider Directory

National Provider Directory

Locations

7005 N Chestnut Ave
Ste 101
Fresno, CA 93720
Phone (559) 299-3949

Practitioners & affiliated clinicians

Practitioners 4

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": "1532476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532476800000",
    "number": "1861979544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7005 N. CHESTNUT AVE STE. 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-299-5949",
            "fax_number": "559-299-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 N. CHESTNUT AVE STE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93720",
            "telephone_number": "559-299-5949",
            "fax_number": "559-299-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL PEDIATRIC DENTISTRY CHESTNUT PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-25",
        "last_updated": "2018-07-25",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "559-299-3949",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "56148",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "101165",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2018; 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.