PEDIATRIC DENTISTRY OF LOS ALTOS (NPI# 1679797930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679797930 |
| Entity Type | Organization |
| Organization Name | PEDIATRIC DENTISTRY OF LOS ALTOS |
| Other Organization Name | PEDIATRIC DENTISTRY OF LOS ALTOS |
| Practice Address |
731 Altos Oaks Dr Los Altos CA 94024-5402 |
| Practice Telephone | 6509486884 |
| Practice Fax Number | 6509487244 |
| Mailing Telephone | 6509486884 |
| Mailing Fax Number | 6509487244 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES KELLY (DENTIST) |
| Authorized Official Telephone | 6509486884 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
30395 | CA | Dental Providers |
| X | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
38101 | CA | Dental Providers |
| X | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
21718 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| pediatric dentistry of los altos | Doing Business As Name - Organization |
| Street Address |
731 ALTOS OAKS DR |
| City | LOS ALTOS |
| State | CA |
| Zip Code | 94024-5402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801207519 | Nick Gorgani | Dentist | 731 Altos Oaks Dr, Los Altos, CA 94024-5402 | 2014-05-15 |
| 1710108683 | Shiva Sheikholeslam | Dentist | 731 Altos Oaks Dr, Los Altos, CA 94024-5402 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912383431 | Panakos Acupuncture Clinic | Clinic/Center | 851 Fremont Ave, Suite 114, Los Altos, CA 94024 | 2015-08-06 |
| 1487030078 | Nicole Lew | Physical Therapist | 1330 Bright Oaks Ct., Los Altos, CA 94024 | 2015-08-05 |
| 1255718144 | Ciara Johnson | Physical Medicine & Rehabilitation | 1635 Candace Way, Los Altos, CA 94024 | 2015-04-30 |
| 1639479744 | Eileen R Goldman | Marriage & Family Therapist | 2551 Grant Road, Mountain View, CA 94024 | 2010-10-25 |
| 1285890368 | Neilesh Shashikant Patel | Dentist | 595 Loyola, Los Altos, CA 94024 | 2008-07-29 |
| 1841478328 | Alejandro A Zaffaroni Md Inc | Ophthalmology | 762 Altos Oaks Drive, Suite 1, Los Altos, CA 94024 | 2008-02-06 |
| 1710164843 | Donald Robert Watters | Dentist | 851 Fremont Ave., Suite 101, Los Altos, CA 94024 | 2008-01-31 |
| 1508060443 | Verna Lee Stivender | Durable Medical Equipment & Medical Supplies | 1564 Miramonte Avenue, #a, Los Altos, CA 94024 | 2007-06-13 |
| 1770700627 | Deborah Amy Rovine | Psychiatry & Neurology | 1000 Fremont Ave Ste 250d, Los Altos, CA 94024 | 2007-04-20 |
| 1669503082 | Sheila Huang Humphries | Internal Medicine | 811 Altos Oaks Drive, Suite 2, Los Altos, CA 94024 | 2007-03-08 |
| Find all providers in zip 94024 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801207519 | Nick Gorgani | Dentist | 731 Altos Oaks Dr, Los Altos, CA 94024-5402 | 2014-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385227 | Johnson Ann Wong Dental Corporation | Dentist | 6512 N Figueroa St Ste 3, Los Angeles, CA 90042-2155 | 2020-10-26 |
| 1205440211 | Jessica Choi, Dmd, Dental Corporation | Dentist | 2318 Huntington Dr, San Marino, CA 91108-2641 | 2020-09-08 |
| 1659985802 | Rw Fattouch Dmd, Inc. | Dentist | 42210 Lyndie Ln Ste 100, Temecula, CA 92591-3604 | 2020-09-04 |
| 1174136998 | Armand Begian Dds Inc. | Dentist | 4021 Mission Oaks Blvd # 180, Camarillo, CA 93012-5156 | 2020-08-31 |
| 1164035473 | Armand Begian Dds Inc. | Dentist | 3687 Las Posas Rd Ste 180, Camarillo, CA 93010-1431 | 2020-08-26 |
| 1518577972 | Michael Vincent Laureola Dds Inc | Dentist | 2862 Unit A Canyon Springs Parkway, Riverside, CA 92507 | 2020-07-31 |
| 1396360384 | Drs Salem and Soliman Dental Corp | Dentist | 2119 E Hatch Rd Ste Bandc, Modesto, CA 95351-4814 | 2020-06-15 |
| 1689299471 | Abhishek Batra | Dentist | 11052 Evans St, Loma Linda, CA 92354-2709 | 2020-06-08 |
| 1194348060 | Bryan Chao | Dentist | 1895 Mowry Ave Ste 121, Fremont, CA 94538-1736 | 2020-05-26 |
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| Find all providers with the same taxonomy | ||||
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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.