PEITI SU (NPI# 1104055235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104055235 |
| Entity Type | Individual |
| Full Name | PEITI SU |
| Credential | DDS |
| Practice Address |
1721 La Playa Way Sacramento CA 95864-1508 |
| Mailing Address |
4300 Berrendo Dr Sacramento CA 95864-3120 |
| Practice Telephone | 9164323431 |
| Mailing Telephone | 9164323431 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2013-03-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
055065-1 | NY | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
62032 | CA | Dental Providers |
| Street Address |
1721 LA PLAYA WAY |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95864-1508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831328962 | Samuel Sun | Dentist | 1721 La Playa Way, Sacramento, CA 95864-1508 | 2009-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407239403 | Neda Afshar | Nurse Practitioner | 840 Laverstock Way, Sacramento, CA 95864 | 2015-07-08 |
| 1952738270 | Marshall Gollub | Psychiatry & Neurology | 1400 Jonas Ave., Sacramento, CA 95864 | 2013-10-01 |
| 1235565573 | Peter Alexander Hagens Jr. | Pharmacist | 930 Somersby Way, Sacramento, CA 95864 | 2013-09-18 |
| 1700054020 | Summit Psychotherapy Associates, PC | Psychologist | 3610 American River Drive, Suite 140, Sacramento, CA 95864 | 2008-02-20 |
| 1619917887 | Jayanthi Meena Kasiraj | Psychologist | 2708 Latham Drive, Sacramento, CA 95864 | 2006-06-07 |
| 1790259141 | Elizabeth Morales | Behavior Technician | 591 Watt Ave, Sacramento, CA 95864 | 2019-01-18 |
| 1033636261 | Sarah Leary | Speech-Language Pathologist | 3205 Hurley Way, Sacramento, CA 95864 | 2017-08-28 |
| 1063933786 | Kirsten Elisabeth Sorensen | Pharmacist | 3240 Arden Way, Sacramento, CA 95864 | 2017-07-03 |
| 1104298033 | Bufcsac PC | Clinic/Center | 4345 Arden Way, Sacramento, CA 95864 | 2015-10-30 |
| 1811323710 | Emily Renee Reisinger | Physician Assistant | 2625 Fair Oaks Blvd, #1, Sacramento, CA 95864 | 2013-09-24 |
| Find all providers in zip 95864 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629459227 | Harkeet Sappal | Dentist | 2830 G St Ste 100, Sacramento, CA 95816-3784 | 2015-06-09 |
| 1447463120 | Philip Jon Hankins | Dentist | 1217 26th St, Sacramento, CA 95816-5617 | 2007-05-08 |
| 1992870745 | Robert Hunter Sharp | Dentist | 2 Scripps Dr Ste 210, Sacramento, CA 95825-6207 | 2006-11-21 |
| 1497145064 | S Jang Dds Incorporated | Dentist | 3433 Arden Way, Sacramento, CA 95825-2018 | 2015-02-03 |
| 1972840296 | Brandon J Webb | Dentist | 2322 Butano Dr, Suite 212a, Sacramento, CA 95825-0629 | 2013-01-07 |
| 1609182203 | Keith Richard Boyer | Dentist | 1217 26th St, Sacramento, CA 95816-5617 | 2010-08-20 |
| 1316129935 | Drs. Whitnack, Keating, Greene & Bal, A Dental Corporation | Dentist | 1810 Professional Dr, Suite A, Sacramento, CA 95825-2165 | 2007-12-05 |
| 1275727513 | Andrew Sean Barak | Dentist | 1315 Alhambra Blvd, Suite 340, Sacramento, CA 95816-5244 | 2007-08-29 |
| 1700087913 | Cary Craig Syamken | Dentist | 1315 Alhambra Blvd, Suite 340, Sacramento, CA 95816-5244 | 2007-05-29 |
| 1700090750 | Fernando Hugo Solano | Dentist | 1217 26th St, Sacramento, CA 95816-5617 | 2007-05-09 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95864 |
Please comment or provide details below to improve the information on PEITI SU.
| 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.