NORTH JACKSON DENTAL GROUP (NPI# 1023023884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023023884 |
| Entity Type | Organization |
| Organization Name | NORTH JACKSON DENTAL GROUP |
| Practice Address |
125 N Jackson Ave Suite #104 San Jose CA 95116 |
| Practice Telephone | 4089238272 |
| Practice Fax Number | 4089238211 |
| Mailing Telephone | 4089238272 |
| Mailing Fax Number | 4089238211 |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. HUE MY TO (VICE PRESIDENT OF THE CORPORATION) |
| Authorized Official Telephone | 4089238272 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 23951 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G9089201 | 05 |
| Street Address |
125 N JACKSON AVE SUITE #104 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215910609 | Kirk Charles Zobac | Physical Therapist | 125 N Jackson Ave, #104, San Jose, CA 95116-1903 | 2005-11-21 |
| 1740696244 | Xining Fu | Acupuncturist | 125 N Jackson Ave, Suite 210, San Jose, CA 95116-1903 | 2014-07-03 |
| 1770823866 | Emily Johannah Peters-limbeck | Nurse Practitioner | 125 N Jackson Ave, San Jose, CA 95116-1903 | 2013-02-26 |
| 1013282102 | Hector S Cerezo Md Inc | Clinic/Center | 125 N Jackson Ave, Suite 110, San Jose, CA 95116-1903 | 2012-03-21 |
| 1093083651 | Marietta Abalos-galito, Md Inc | Internal Medicine | 125 N Jackson Ave, Suite Number 107, San Jose, CA 95116-1903 | 2011-12-09 |
| 1003198326 | Arline G Guinto Macaraeg | Dentist | 125 N Jackson Ave, Suite 207, San Jose, CA 95116-1903 | 2011-09-13 |
| 1518173608 | Reena K Ranpuria | Internal Medicine | 125 N Jackson Ave, Suite 109, San Jose, CA 95116-1903 | 2007-05-15 |
| 1437277092 | Marietta Florence Abalos-galito | Internal Medicine | 125 N Jackson Ave, Suite 107, San Jose, CA 95116-1903 | 2007-03-26 |
| 1295851467 | Anthony S. Alvarado, M.d., Inc. | Orthopaedic Surgery | 125 N Jackson Ave, Suite # 101, San Jose, CA 95116-1903 | 2007-03-21 |
| 1831233782 | Thomas Gallardo | Chiropractor | 125 N Jackson Ave, Suite 107, San Jose, CA 95116-1903 | 2007-02-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570102 | Lori Chung Cho Dmd Inc. | Clinic/Center | 150 N Jackson Ave Ste 103, San Jose, CA 95116 | 2018-09-03 |
| 1306333174 | Patrick Suezaki | Dentist | 250 Montclair Ave Ste C, San Jose, CA 95116 | 2018-04-17 |
| 1871016147 | Israel Enrique Ruiz Lora | Social Worker | 1075 East Santa Clara, San Jose, CA 95116 | 2017-07-19 |
| 1275072613 | Araceli Yazmin Garcia | Case Manager/Care Coordinator | 1652 E San Fernando St, San Jose, CA 95116 | 2017-02-17 |
| 1710304712 | Natalie K. Huynh D.d.s Inc. | Dentist | 2340 Mckee Rd #24, San Jose, CA 95116 | 2014-03-27 |
| 1437597747 | Ian Ellis Mccoy | Internal Medicine | 2360 Mckee Rd Ste 10, San Jose, CA 95116 | 2013-06-08 |
| 1588913321 | Adrian Fernandez | Counselor | 1245 East Santa Clara Street, San Jose, CA 95116 | 2012-09-07 |
| 1851678841 | Krystal Lani Subia | Counselor | 101 Jose Figueres Avenue, San Jose, CA 95116 | 2011-11-04 |
| 1255668224 | Sophia O.j.m. Dijkstra | Physical Therapist | 180 N. Jackson Ave, San Jose, CA 95116 | 2009-11-11 |
| 1255562096 | Jovan De Guzman Sedilla | Physical Therapy Assistant | 180 N. Jackson Ave., San Jose, CA 95116 | 2009-07-28 |
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| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| 1306445689 | Vu Anh Tran | Dentist | 45 Via De Guadalupe, San Jose, CA 95116-2561 | 2020-10-19 |
| 1538775028 | Meera Sravan Kumar | Dentist | 451 Blossom Hill Rd Ste 20, San Jose, CA 95123-1658 | 2020-09-20 |
| 1750993937 | Ana Gloria Saint-hilaire | Dentist | 4676 Mia Cir, San Jose, CA 95136-2341 | 2020-08-19 |
| 1134746779 | Woodlief Dentistry & Associates, PC | Dentist | 750 N Capitol Ave Ste A2, San Jose, CA 95133-1902 | 2020-06-30 |
| 1871120485 | Brittany Chou | Dentist | 136 Birch Ln, San Jose, CA 95127-2310 | 2020-03-24 |
| 1164054235 | Amritha Raghunath Minisandram | Dentist | 7058 Heartland Way, San Jose, CA 95135-2234 | 2020-02-06 |
| 1124582580 | Mahsa Esfandiari | Dentist | 1706 Morocco Dr, San Jose, CA 95125-5823 | 2019-01-29 |
| 1689138547 | Quan Phuong Huynh | Dentist | 1855 Alum Rock Ave Ste B, San Jose, CA 95116-1398 | 2019-01-24 |
| 1790257848 | Sandra P. Lara Dds . Inc | Dentist | 1360 N Winchester Blvd Ste 3, San Jose, CA 95128-1150 | 2018-12-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.