Dr.Robert E.Jarvis II, a California Professional Dental Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

CA29956 Issued in CA

Legal business name

DR.ROBERT E.JARVIS II, A CALIFORNIA PROFESSIONAL DENTAL CORPORATION

Practice address

8741 Brooks Rd S
Suite #101
Windsor, CA 95492-7853

Phone

(707) 838-8836

Fax

(707) 838-1858

NPI assigned

Oct 4, 2011

Organization subpart

No

Name

Dr. Robert Elton Jarvis II, DDS

Title

Owner/Doctor

Phone

(707) 838-8836

Tax ID family

Drrobert E Jarvis II a California Professional Dental Corporation2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dr.Robert E. Jarvis II, a California Professional Dental Corporation

  • Oral and Maxillofacial Surgery (Dentist)
  • Santa Rosa, CA
  • NPI 1922380781
  NPD tax ID

Locations

• Windsor Oral Surgery Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 4, 2011.

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1902180334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8741 BROOKS RD S",
            "address_2": "SUITE #101",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954927853",
            "telephone_number": "707-838-8836",
            "fax_number": "707-838-1858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8741 BROOKS RD S",
            "address_2": "SUITE #101",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954927853",
            "telephone_number": "707-838-8836",
            "fax_number": "707-838-1858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.ROBERT E.JARVIS II, A CALIFORNIA PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ELTON",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "707-838-8836",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "CA29956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windsor Oral Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• All providers in Windsor, CA
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.