SERGIO VICUNA, D.D.S., INC (NPI# 1275089963) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275089963 |
| Entity Type | Organization |
| Organization Name | SERGIO VICUNA, D.D.S., INC |
| Other Organization Name | MIDTOWN MODERN DENTAL GROUP |
| Practice Address |
1804 19th St Suite 100 Sacramento CA 95811 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 9162460889 |
| Practice Fax Number | 9164588468 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |
| Authorized Official Name | DR. SERGIO VICUNA (OWNER) |
| Authorized Official Telephone | 9162460889 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Midtown Modern Dental Group | Doing Business As Name - Organization |
| Street Address |
1804 19TH ST SUITE 100 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95811 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154891190 | Teresa Sy | Behavior Technician | 610 Bercut Dr. Suite B, Sacramento, CA 95811 | 2018-12-03 |
| 1669948212 | Micaela Badue | Counselor | 401 S St., Sacramento, CA 95811 | 2018-10-22 |
| 1669956801 | Andrea Martinez | Counselor | 600 Bercut Dr., Sacramento, CA 95811 | 2018-09-24 |
| 1174000855 | Clinicians Connect Care Home Health & Hospice Services | Home Health | 716 19th Street, Suite 200, Sacramento, CA 95811 | 2018-07-25 |
| 1992202345 | Benjamin James Leibold | Behavior Technician | 610 Bercut Drive, Suite B, Sacramento, CA 95811 | 2018-04-11 |
| 1669979233 | Aja Jones | Counselor | 401 S Street, Sacramento, CA 95811 | 2018-04-10 |
| 1821511916 | Lucas John Monaco | Counselor | 1400 North 'a' Street, Bldg A, Sacramento, CA 95811 | 2017-07-20 |
| 1386057495 | Chelsea Turner | Counselor | 600 Bercut Drive, Sacramento, CA 95811 | 2014-06-05 |
| 1427473636 | Sidney Caldwell | Counselor | 401 S Street Sacramento, Sacramento, CA 95811 | 2014-02-25 |
| 1265773394 | Jacquelyn L Rivers | Social Worker | 1400 North A Street, Building A, Sacramento, CA 95811 | 2013-03-14 |
| Find all providers in zip 95811 | ||||
| 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 |
|---|---|---|---|---|
| 1679180178 | Shraddha Swain | Dentist | 1164 National Dr Ste 40, Sacramento, CA 95834-1925 | 2020-09-28 |
| 1447867197 | Yasmine Taylor Puentes | Dentist | 1428 U St, Sacramento, CA 95818-1489 | 2020-09-27 |
| 1396375812 | Euridise Munoz De Anda | Dentist | 3311 Watt Ave Ste A, Sacramento, CA 95821-3617 | 2020-01-23 |
| 1114577343 | Ahmad Mokbil Dds Inc | Dentist | 992 Florin Rd, Sacramento, CA 95831-3515 | 2019-09-19 |
| 1538722798 | Yun Hwan Oh Dental Corporation | Dentist | 3521 Arden Way Ste 101, Sacramento, CA 95864-2911 | 2019-04-15 |
| 1093289621 | Western Dental Services, Inc. | Dentist | 3945 Marysville Blvd Ste 1-2, Sacramento, CA 95838-3762 | 2019-01-16 |
| 1659860690 | S.y.y Jang Dds Corp | Dentist | 3433 Arden Way Ste C, Sacramento, CA 95825-2018 | 2018-05-04 |
| 1992213623 | Lee Lo | Dentist | 719 Roundtree Ct, Sacramento, CA 95831-2678 | 2018-01-16 |
| 1982123279 | Gill Bautista and Lopez Dental Corporation | Dentist | 8204 Delta Shores Cir S Ste 140, Sacramento, CA 95832-9101 | 2017-09-18 |
| 1609391549 | Sooraj Singh | Dentist | 1007 Rio Cidade Way, Sacramento, CA 95831-4467 | 2017-08-11 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95811 |
Please comment or provide details below to improve the information on SERGIO VICUNA, D.D.S., INC.
| 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.