DR. CORRINE ANN CLINE-FORTUNATO (NPI# 1225142649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225142649 |
| Entity Type | Individual |
| Full Name | DR. CORRINE ANN CLINE-FORTUNATO |
| Credential | DDS |
| Practice Address |
223 Mount Hermon Road Suite B Scotts Valley CA 95066 |
| Practice Telephone | 8314309910 |
| Practice Fax Number | 8314309914 |
| Mailing Telephone | 8314309910 |
| Mailing Fax Number | 8314409914 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2008-05-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
41379 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DEA | BC4006943 | 01 |
| CA | GA PERMIT | 1098 | 01 |
| CA | ANESTHESIA LICENSE | 1098 | 01 |
| Street Address |
223 MOUNT HERMON ROAD SUITE B |
| City | SCOTTS VALLEY |
| State | CA |
| Zip Code | 95066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861046377 | Nannette Benedict Dds Associates | Dentist | 5015 Scotts Valley Drive, Scotts Valley, CA 95066 | 2019-08-01 |
| 1457836314 | Erin Burton Josselyn | Social Worker | 125 Bethany Dr Ste 203, Scotts Valley, CA 95066 | 2018-09-26 |
| 1770010068 | Onesource Compounding Pharmacy | Pharmacy | 104 Whispering Pines Dr Ste 105, Scotts Valley, CA 95066 | 2017-05-17 |
| 1912393612 | Living Evolution: An Outdoor Experiential Learning Program Inc. | Nutritionist | 6001 Buttler Lane, Suite 206, Scotts Valley, CA 95066 | 2015-04-09 |
| 1750638375 | Denise Louise Quinn | Physical Therapist | 108 Whispering Pines Drive, Scotts Valley, CA 95066 | 2012-08-14 |
| 1194047100 | Kim Ann Chavez | Registered Nurse | 3650 Graham Hill Road, Juvenile Hall Nursing Unit, Santa Cruz, CA 95066 | 2010-02-17 |
| 1972755536 | Bethany University Counseling Center | Marriage & Family Therapist | 800 Bethany Drive, Scotts Valley, CA 95066 | 2008-10-15 |
| 1336343383 | Ali Eppy | Marriage & Family Therapist | 4113 Scotts Valley Drive, Suite 205, Scotts Valley, CA 95066 | 2007-06-13 |
| 1699825265 | Julie Carboni | Marriage & Family Therapist | 125 Bethany Drive Ste. N, Scotts Valley, CA 95066 | 2007-01-12 |
| 1902982143 | John A Stevens Dds Inc | Dentist | 221 H Mount Hermon Road, Scotts Valley, CA 95066 | 2006-10-31 |
| Find all providers in zip 95066 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
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| 1942807979 | Ayed Hawatmeh Dds Inc | Dentist | 322 E Foothill Blvd, Pomona, CA 91767 | 2020-10-02 |
| 1114533064 | Alexander V. Antipov, D.d.s., Inc. | Dentist | 911 Reserve Drive, Suite 150, Roseville, CA 95678 | 2020-09-16 |
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1316568900 | Beech & Reid Dental Partnership | Dentist | 464 E Calaveras Blvd Ste B3, Milpitas, CA 95035-5412 | 2020-05-05 |
| 1518506773 | Francisco Suarez, Dds Inc. | Dentist | 4606 Hollywood Blvd Ste A, Los Angeles, CA 90027-5462 | 2020-01-04 |
| 1831748839 | Slate Dental Corporation | Dentist | 6512 Lonetree Blvd Ste 100, Rocklin, CA 95765-5883 | 2019-09-11 |
| 1255980140 | Dr Maloux Macasaet Saguin Dental Corporation | Dentist | 9800 Topanga Canyon Blvd Ste J, Chatsworth, CA 91311-4075 | 2019-09-04 |
| 1891342267 | Amrollahie and Riman Dental Partnership | Dentist | 1442 Irvine Blvd Ste 225, Tustin, CA 92780-3846 | 2019-08-21 |
| 1548821572 | Hoang Dental Corporation | Dentist | 1356 W Valley Pkwy Ste J, Escondido, CA 92029-2138 | 2019-06-20 |
| 1073173860 | Omfs Care Center Partners | Dentist | 215 N Fresno St Ste 490, Fresno, CA 93701-0000 | 2019-06-14 |
| Find all providers with the same taxonomy | ||||
| City | SCOTTS VALLEY |
| Zip Code | 95066 |
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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.