NPIMap

Organization Active NPI

Maria Teresa R de Guzman DDS Corp

  • Preferred Provider Organization
  • Fair Oaks, CA
National Provider Identifier
1932650249
Registry record updated Oct 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
41390 Issued in CA
Legal business name
MARIA TERESA R DE GUZMAN DDS CORP
Practice address
5060 Sunrise Blvd
Suite A1
Fair Oaks, CA 95628-4944
Phone
(916) 863-0456
Fax
(916) 910-0751
NPI assigned
Oct 21, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2016

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

Authorized official

Name
Mr. Anthony E Deguzman
Title
Administrator
Phone
(916) 919-5721

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X 41390 CA
Preferred Provider Organization 305R00000X 41390 CA Primary

Addresses

Primary practice location

5060 Sunrise Blvd
Suite A1
Fair Oaks, CA 95628-4944

Mailing address

5060 Sunrise Blvd
Ste A4
Fair Oaks, CA 95628-4944
Phone (916) 910-0708

Other names 1

  • MYTOOTHSPA DENTISTRY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maria Teresa R de Guzman DDS Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

5060 Sunrise Blvd
Ste A4
Fair Oaks, CA 95628

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1932650249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 SUNRISE BLVD",
            "address_2": "STE A4",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284944",
            "telephone_number": "916-910-0708",
            "fax_number": "916-910-0751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 SUNRISE BLVD",
            "address_2": "SUITE A1",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956284944",
            "telephone_number": "916-863-0456",
            "fax_number": "916-910-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA TERESA R DE GUZMAN DDS CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "DEGUZMAN",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "916-919-5721",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "41390",
            "primary": false
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "41390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MYTOOTHSPA DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.