NPIMap

Organization Active NPI

Sergio Pereira & Simonne Patrick, DDS a Prof Corp

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1972038321
Registry record updated Apr 24, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43387 Issued in CA
Legal business name
SERGIO PEREIRA & SIMONNE PATRICK, DDS A PROF CORP
Doing business as
design dental
Practice address
5700 Whitelock Pkwy
#120
Elk Grove, CA 95757-5925
Phone
(916) 714-3344
NPI assigned
Apr 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2017

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

Authorized official

Name
Dr. Sergio PereiraNPI 1679650360
Title
President
Phone
(916) 714-3344

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 43387 CA Primary

Addresses

Primary practice location

5700 Whitelock Pkwy
#120
Elk Grove, CA 95757-5925

Mailing address

5700 Whitelock Pkwy
#120
Elk Grove, CA 95757-5925
Phone (916) 714-3344

Other names 1

  • design dental Doing business as

National Provider Directory

National Provider Directory

Locations

5700 Whitelock Pkwy
Ste 120
Elk Grove, CA 95757
Phone (916) 714-3344

Practitioners & affiliated clinicians

Practitioners 2

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": "1492992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1972038321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 WHITELOCK PKWY",
            "address_2": "#120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575925",
            "telephone_number": "916-714-3344",
            "fax_number": "916-714-3304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 WHITELOCK PKWY",
            "address_2": "#120",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957575925",
            "telephone_number": "916-714-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERGIO PEREIRA & SIMONNE PATRICK, DDS A PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-24",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-714-3344",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "design 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 Apr 24, 2017; 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.