DR. STACIE DAWN FENDERSON (NPI# 1053500959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053500959 |
| Entity Type | Individual |
| Full Name | DR. STACIE DAWN FENDERSON |
| Credential | DDS MS |
| Practice Address |
8689 Folsom Blvd Sacramento CA 95826 |
| Mailing Address |
350 Meadow Gate Rd Meadow Vista CA 95722 |
| Practice Telephone | 9163817171 |
| Practice Fax Number | 9163811171 |
| Mailing Telephone | 9163817171 |
| Mailing Fax Number | 5308781470 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2007-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
52724 | CA | Dental Providers |
| Street Address |
8689 FOLSOM BLVD |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972908051 | Jared G. Danielson, Dds, Dental Corporation | Dentist | 8689 Folsom Blvd, Sacramento, CA 95826-3708 | 2014-10-31 |
| 1063782118 | Christian Hoybjerg Dds, A Professional Dental Corp. | Dentist | 8689 Folsom Blvd, Sacramento, CA 95826 | 2012-01-06 |
| 1902173206 | Robert Mcclurg, Dds A Professional Dental Corporation | Dentist | 8689 Folsom Blvd, Sacramento, CA 95826-3708 | 2011-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326688094 | Brooke Oliver | Behavior Technician | Sacramento 8801 Folsom Blvd., Ste. 195, Sacramento, CA 95826 | 2020-01-10 |
| 1679126908 | Albert Einstein Middle School /sacramento City Unified School District | Local Education Agency (LEA) | 9325 Mirandy Drive, Albert Einstein Middle School, Sacramento, CA 95826 | 2019-07-16 |
| 1487146833 | Sarah Collins | Counselor | 4212 Westporter Dr, Sacramento, CA 95826 | 2018-06-01 |
| 1831609221 | Stacey Ann Moote | Behavior Technician | 8795 La Riviera Dr 169, 169, Sacramento, CA 95826 | 2017-10-11 |
| 1033649041 | Joseph Stephen Rapozo | Counselor | 3600 Power Inn Road, Sacramento, CA 95826 | 2017-06-13 |
| 1497201289 | Maureen Belli-bomgardner | Counselor | 3201 Florin Perkins Road, Sacramento, CA 95826 | 2016-08-31 |
| 1316317613 | Tlcs, Inc. | Community/Behavioral Health | 9342 Tech Center Drive, Ste.600, Sacramento, CA 95826 | 2015-09-29 |
| 1942683479 | Tlcs, Inc. | Community/Behavioral Health | 9333 Tech Center Drive, Ste. 100, Sacramento, CA 95826 | 2015-07-01 |
| 1881071157 | Rene Frentzen | Case Manager/Care Coordinator | 9394 Tech Center Drive, Suite 200, Sacramento, CA 95826 | 2015-05-06 |
| 1184026262 | Bojana Pandurevic | Marriage & Family Therapist | 9343 Tech Center Drive, Suite 200, Sacramento, CA 95826 | 2014-09-21 |
| Find all providers in zip 95826 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245854157 | G. Adams Dds, Inc. | Dentist | 10315 Tranquil Glen Ct, Sacramento, CA 95829-6579 | 2020-06-05 |
| 1174176903 | Andrew Laflamme | Dentist | 3960 El Camino Ave Ste 6, Sacramento, CA 95821-6534 | 2019-07-21 |
| 1558619197 | Annie Shih, Dds, Inc | Dentist | 2237 Park Towne Cir Ste 1, Sacramento, CA 95825-0417 | 2012-08-28 |
| 1922380310 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 4150 Truxel Road, Suite B, Sacramento, CA 95834 | 2011-09-13 |
| 1851618441 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1580 Howe Ave, Sacramento, CA 95825 | 2010-04-23 |
| 1649445057 | Nimrat K Heir | Dentist | 3645 Northgate Blvd Ste A, Sacramento, CA 95834-1641 | 2008-04-25 |
| 1093833808 | Damon Peter Szymanowski | Dentist | 2 Scripps Dr Ste 303, Sacramento, CA 95825-6207 | 2007-03-27 |
| 1821128489 | Jennifer Lynn Drew | Dentist | 3960 El Camino Avenue Ste. 6, Sacramento, CA 95821 | 2007-03-06 |
| 1750418620 | David Lee Markham | Dentist | 2420 Del Paso Rd Ste 125, Sacramento, CA 95834-9678 | 2007-02-27 |
| 1336282789 | Melvin W. Walters | Dentist | 4450 Duckhorn Drive, Suite B, Sacramento, CA 95834 | 2007-02-15 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95826 |
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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.