NPIMap

Organization Active NPI

Pacific Dental Services

  • Dentist
  • Brentwood, CA
National Provider Identifier
1992181911
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64819 Issued in CA
Legal business name
PACIFIC DENTAL SERVICES
Practice address
6660 Lone Tree Way Ste 7
Brentwood, CA 94513-5310
Phone
(925) 513-8363
NPI assigned
Jul 31, 2015
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Matt Paul
Title
Office Manager
Phone
(925) 513-8363

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 64819 CA Primary

Addresses

Primary practice location

6660 Lone Tree Way Ste 7
Brentwood, CA 94513-5310

Mailing address

6660 Lone Tree Way Ste 7
Brentwood, CA 94513-5310

National Provider Directory

National Provider Directory
Tax ID family
Amardeep Gill DDS Inc2 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.

Locations

6660 Lone Tree Way
Ste 7
Brentwood, CA 94513
Phone (925) 490-1865

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1992181911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6660 LONE TREE WAY STE 7",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6660 LONE TREE WAY STE 7",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135310",
            "telephone_number": "925-513-8363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "PAUL",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "925-513-8363"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "64819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.

Verify at the official NPI Registry.