CENTRAL COAST PEDIATRIC DENTAL GROUP (NPI# 1033242144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033242144 |
| Entity Type | Organization |
| Organization Name | CENTRAL COAST PEDIATRIC DENTAL GROUP |
| Practice Address |
945 Blanco Circle Suite D Salinas CA 93901 |
| Mailing Address |
631 E Alvin Drive Suite C Salinas CA 93906 |
| Practice Telephone | 8314240641 |
| Practice Fax Number | 8314240888 |
| Mailing Telephone | 8314428878 |
| Mailing Fax Number | 8314434611 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. ANNA M LIZAOLA (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 8314428878 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
37400 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G9087501 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942333059 | Central Coast Pediatric Dental Group | Dentist | 1717 Fremont Blvd, Seaside, CA 93955 | 2007-03-14 |
| 1205922705 | Central Coast Pediatric Dental Group | Dentist | 631 E Alvin Drive, Suite B, Salinas, CA 93906 | 2006-10-04 |
| Street Address |
945 BLANCO CIRCLE SUITE D |
| City | SALINAS |
| State | CA |
| Zip Code | 93901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043811482 | Ofelia Stephanie Gonzalez | Social Worker | 252 San Jose St. Upstairs Suite, Salinas, CA 93901 | 2020-11-03 |
| 1881222198 | Megan Emery | Occupational Therapist | Monterey County Office of Education, 901 Blanco Circle, Salinas, CA 93901 | 2020-03-31 |
| 1083171433 | Leeann Rose Gutierrez | Behavior Technician | 505 E Romie Lane, Suite E, Salinas, CA 93901 | 2019-02-21 |
| 1043784853 | Jeanne Miranda Gapac Brady | Pharmacy | 420 East Romie Lane, Salinas, CA 93901 | 2019-01-15 |
| 1164994422 | Epigmenio Vazquez | Behavior Technician | 505 E Romie Lane, Salinas, CA 93901 | 2018-12-27 |
| 1043709751 | Stephanie Gailo | Registered Nurse | Dept of Social Services, Family & Children's Services., 1000 S. Main St. Ste 205, Salinas, CA 93901 | 2018-05-08 |
| 1912405846 | Elizabeth Zaragoza | Counselor | 130 W. Gabilan Street, Salinas, CA 93901 | 2018-01-25 |
| 1144749540 | Shelby Lynn Hyosaka | Registered Nurse | 333 Abbott St. - United Ag Health and Wellness Center, Ste. A, Salinas, CA 93901 | 2017-09-17 |
| 1275058075 | Marisol Jacobo | Social Worker | 41 E San Luis St., Salinas, CA 93901 | 2017-08-14 |
| 1225484959 | Kristen Ryan Russell | Occupational Therapist | Windsor Gardens Center of Rehabilitation, 637 E Romie Ln, Salinas, CA 93901 | 2016-05-12 |
| Find all providers in zip 93901 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457770059 | Jacqueline Nguyen | Dentist | 945 Blanco Cir Ste D, Salinas, CA 93901-4421 | 2014-04-10 |
| 1477649960 | Ray Edward Stewart | Dentist | 631 E Alvin Drive, Suite B, Salinas, CA 93096 | 2006-10-04 |
| 1952497448 | Marielena Murillo | Dentist | 633 E Alvin Drive, Suite B, Salinas, CA 93906 | 2006-10-04 |
| 1669568168 | Paul J Morris | Dentist | 633 E Alvin Dr Suite B, Salinas, CA 93906 | 2006-10-04 |
| 1487740973 | Charles Edwin Sackett Iv | Dentist | 633 E Alvin Drive Ste B, Salinas, CA 93906 | 2006-10-04 |
| 1255627592 | Jennifer Lo | Dentist | 1045 Los Palos Dr, Salinas, CA 93901-3916 | 2011-06-24 |
| 1598085078 | Pooja Rattan | Dentist | 631 E Alvin Dr, Suite C, Salinas, CA 93906-3056 | 2010-06-07 |
| 1457481525 | Seth L Reder | Dentist | 631 E Alvin Dr, Suite E, Salinas, CA 93906-3056 | 2007-03-06 |
| 1063596815 | Jennifer D Morris | Dentist | 631 E Alvin Dr Suite B, Salinas, CA 93906 | 2006-10-25 |
| 1831285329 | Peter Cj Chiang | Dentist | 633 E Alvin Drive, Ste B, Salinas, CA 93906 | 2006-10-04 |
| Find all providers in SALINAS | ||||
Please comment or provide details below to improve the information on CENTRAL COAST PEDIATRIC DENTAL GROUP.
| 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.