Michael Sycamore Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

59942 Issued in CA

Legal business name

MICHAEL SYCAMORE DENTAL CORPORATION

Practice address

1189 Roadrunner Way
Simi Valley, CA 93065-3159

Phone

(626) 808-3793

NPI assigned

May 29, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael Sycamore, DDSNPI 1417184912

Title

President

Phone

(626) 808-3793

Specialties & licenses 1

Addresses

Other names 1

• Sycamore Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael J Sycamore, DDS

  • General Practice Dentistry
  • Simi Valley, CA
  • NPI 1417184912
  NPD (past) Authorized official

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1982964656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4209 VIA ARBOLADA UNIT 134",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900425094",
            "telephone_number": "626-808-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1189 ROADRUNNER WAY",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653159",
            "telephone_number": "626-808-3793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL SYCAMORE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "SYCAMORE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-808-3793",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sycamore Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julie R Meyer, M.S.
• Kristie Meyer, LMFT
• Jennifer Ann Miadich-Freilich, SLP-CCC
• Michael Benjmain, M.D., Inc.
• Michael R. Drucker, M.D. a Medical Corporation
• Brooks Carlton Michaels, MD
• Midvalley RX Pharmacy
• Ilan Migdali, L.AC
• Lesley Migdali, L.AC
• Armine E Mikayelian

• General Practice Dentistry in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.