DR. YOLANDA MARYE MANGRUM (NPI# 1578697546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578697546 |
| Entity Type | Individual |
| Full Name | DR. YOLANDA MARYE MANGRUM |
| Credential | D.D.S. |
| Practice Address |
1301 Southpoint Blvd Ste A Petaluma CA 94954-6858 |
| Practice Telephone | 7077620067 |
| Practice Fax Number | 7077624782 |
| Mailing Telephone | 7077620067 |
| Mailing Fax Number | 7077624782 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2014-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
44612 | CA | Dental Providers |
| Street Address |
1301 SOUTHPOINT BLVD STE A |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-6858 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154724763 | Mona Mahmoodi Dds Inc | Dentist | 245 Kentucky St Ste E, Petaluma, CA 94952-2877 | 2014-09-28 |
| 1205262664 | Nosti and Gill Dental Corporatiom | Dentist | 401 Kenilworth Dr Ste 960, Petaluma, CA 94952-3406 | 2013-09-17 |
| 1093156242 | Reza K. Aryanpour Dds, A Dental Corporation | Dentist | 1436 Professional Dr Ste 302, Petaluma, CA 94954-6697 | 2013-07-16 |
| 1306183991 | Brian Kent Sibbald | Dentist | 255 Fairview Ct, Petaluma, CA 94952-1627 | 2013-01-16 |
| 1396912242 | Bailey Hudson Graham Iv | Dentist | 1126 B St, Petaluma, CA 94952-4055 | 2008-05-09 |
| 1104001015 | Suryamanga.d.achyuta,dds,inc | Dentist | 1372 N Mcdowell Blvd, Suite#b-1, Petaluma, CA 94954-1179 | 2008-01-09 |
| 1902008204 | David A Straub | Dentist | 511 Hayes Ln, Petaluma, CA 94952-4011 | 2007-05-31 |
| 1811106370 | Yvonne A Szyperski | Dentist | 1580 East Washington St, #101, Petaluma, CA 94954 | 2007-05-22 |
| 1750406013 | Nadia Navid | Dentist | 216 Howard St, Petaluma, CA 94952-2719 | 2007-03-19 |
| 1912045444 | Negar Safapour | Dentist | 515 Hayes Ln, Petaluma, CA 94952-4011 | 2007-02-05 |
| Find all providers in PETALUMA | ||||
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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.