Active NPI
Jacqueline Gopar
- Dental Hygienist
- Ukiah, CA
National Provider Identifier
1972971919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 29291
- Practice address
- 333 Laws Ave
Ukiah, CA 95482-6540 - Phone
- (707) 472-4514
- NPI assigned
- Sep 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 29291 | CA | Primary |
Addresses
Primary practice location
333 Laws Ave
Ukiah, CA 95482-6540
Mailing address
717 N McDowell Blvd SPC 506
Petaluma, CA 94954-1433
Phone (707) 514-9055
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29291 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441670400000",
"number": "1972971919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "717 N MCDOWELL BLVD SPC 506",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949541433",
"telephone_number": "707-514-9055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "333 LAWS AVE",
"city": "UKIAH",
"state": "CA",
"postal_code": "954826540",
"telephone_number": "707-472-4514"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOPAR",
"first_name": "JACQUELINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-09-08",
"last_updated": "2015-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "29291",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ukiah, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.