CHILDRENS DENTAL SURGERY CENTER OF FRESNO INC. (NPI# 1407016850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407016850 |
| Entity Type | Organization |
| Organization Name | CHILDRENS DENTAL SURGERY CENTER OF FRESNO INC. |
| Practice Address |
3796 N Fresno St Ste 103 Fresno CA 93726-5500 |
| Practice Telephone | 5592245437 |
| Mailing Telephone | 5592245437 |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2012-01-17 |
| Authorized Official Name | WILEY M ELICK (OWNER/DIRECTOR) |
| Authorized Official Telephone | 5592245437 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN:F1948 | 05C0001948 | 01 |
| Street Address |
3796 N FRESNO ST STE 103 |
| City | FRESNO |
| State | CA |
| Zip Code | 93726-5500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528520814 | Tania Grijalva Miranda | Behavior Technician | 4910 E. Ashland Ave, Fresno, CA 93726 | 2019-04-04 |
| 1790249894 | Lags Spine and Sportscare Medical Centers, Inc. | Psychologist | 3751 E Shields Avenue, Fresno, CA 93726 | 2019-01-23 |
| 1013481100 | Jill A Perricone | Respiratory Therapist, Registered | 4785 N First St, Fresno, CA 93726 | 2019-01-11 |
| 1285108399 | Leann Lokelani Benton | Respiratory Therapist, Registered | 4785 N. First St, Fresno, CA 93726 | 2019-01-11 |
| 1548745912 | Alina Gonzalez | Counselor | 4440 N. First St., Fresno, CA 93726 | 2018-10-01 |
| 1336622067 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 3751 E Shields Ave, Fresno, CA 93726 | 2018-09-10 |
| 1730676206 | Joanne K Groves | Counselor | 3636 N. First Street, St. 123, Fresno, CA 93726 | 2018-04-19 |
| 1356865679 | Fresno Mental Psychological Health Services, P.C. | Clinic/Center | 4021 N Fresno Street, Ste. 101, Fresno, CA 93726 | 2017-07-28 |
| 1205358819 | Jetinder Singh Ghag | Counselor | 3636 N.first St # 135 and 154, Fresno, CA 93726 | 2017-07-14 |
| 1164897328 | Karam Um Dds Inc | Dentist | 4747 N. First St. #174, Fresno, CA 93726 | 2015-12-14 |
| Find all providers in zip 93726 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255722336 | Northwest Surgical Development of Fresno LLC | Clinic/Center | 7015 N Maple Ave, Ste 102, Fresno, CA 93720-8010 | 2015-02-11 |
| 1396005823 | Ldac Surgery Center, Inc | Clinic/Center | 6153 N Thesta St, Fresno, CA 93710-5266 | 2012-05-17 |
| 1699052886 | Downtown Dental Surgery Center of Fresno | Clinic/Center | 1045 S St, Fresno, CA 93721-1406 | 2011-11-16 |
| 1558672626 | California Colon and Rectal Cancer Screening Center LLC | Clinic/Center | 7121 N Whitney Ave, Fresno, CA 93720-0000 | 2010-06-23 |
| 1528236734 | Sierra Pacific Surgery Center Lp | Clinic/Center | 1630 E Herndon Avenue Ste 100, Fresno, CA 93720-3305 | 2008-02-11 |
| 1558417972 | Sierra Plastic Surgery Center Inc | Clinic/Center | 6153 N Thesta, Fresno, CA 93710-5266 | 2007-01-26 |
| 1336223585 | Peter T. Truong, M.d., Surgical Center, Inc. | Clinic/Center | 9497 N Fort Washington, 103, Fresno, CA 93730-0660 | 2006-10-24 |
| 1225123227 | Comprehensive Pain Management Center, Inc. | Clinic/Center | 7152 N Sharon #104, Fresno, CA 93720 | 2006-10-04 |
| 1982709572 | Vallarine Dental Corporation | Clinic/Center | 2828 Fresno St, Suite 100, Fresno, CA 93721-1327 | 2006-09-14 |
| 1528179603 | Advanced Care Management, Inc. | Clinic/Center | 2838 Mariposa St, Fresno, CA 93721-1308 | 2006-08-31 |
| Find all providers in FRESNO | ||||
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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.