ST. JUDE HOSPITAL, INC. (NPI# 1063534501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063534501 |
| Entity Type | Organization |
| Organization Name | ST. JUDE HOSPITAL, INC. |
| Other Organization Name | ST. JUDE DENTAL CLINIC |
| Practice Address |
7758 Knott Ave Buena Park CA 90620-2420 |
| Practice Telephone | 7145228723 |
| Mailing Telephone | 7145228723 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-11-28 |
| Authorized Official Name | MR. BARRY ROSS (VICE PRESIDENT, HEALTHY COMMUNITIES) |
| Authorized Official Telephone | 7149923164 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 70894F | 05 |
| Other Name | Type Code |
|---|---|
| St. Jude Dental Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336262344 | St. Jude Hospital, Inc. | Clinic/Center | 731 South Highland Avenue, Fullerton, CA 92832 | 2007-04-06 |
| 1932324555 | St. Jude Hospital, Inc. | Clinic/Center | 731 South Highland Avenue, Fullerton, CA 92832 | 2007-04-17 |
| 1386869907 | St. Jude Hospital, Inc. | Clinic/Center | 731 South Highland Avenue, Fullerton, CA 92832 | 2007-04-17 |
| Street Address |
7758 KNOTT AVE |
| City | BUENA PARK |
| State | CA |
| Zip Code | 90620-2420 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225397409 | St. Jude Neighborhood Health Centers | Clinic/Center | 7758 Knott Ave, Buena Park, CA 90620-2420 | 2012-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346889110 | Soon Ae Yoon | Acupuncturist | 8600 Beach Blvd. #104, Buena Park, CA 90620 | 2019-12-27 |
| 1649755380 | Rosemary Lynn Nielsen | Social Worker | 1850 Knott Ave, Buena Park, CA 90620 | 2018-09-28 |
| 1730608118 | Arpita Bhavsar | Pharmacist | 7072 Santa Marta Circle, Buena Park, CA 90620 | 2017-09-16 |
| 1740715663 | Gabriela Peinado | Assistant Behavior Analyst | 8669 Holder St, Buena Park, CA 90620 | 2017-04-28 |
| 1679958862 | Aum Pharmacy Corporation | Pharmacy | 6970 Aragon Circle, # 3, Buena Park, CA 90620 | 2015-07-29 |
| 1457600330 | Daniel D. Chung Dds Inc | Dentist | 8884 Knott Ave., Buena Park, CA 90620 | 2012-09-06 |
| 1942531447 | Baltazar Mendoza | Dental Assistant | 7691 El Chaco Drive, Buena Park, CA 90620 | 2010-01-22 |
| 1760509947 | Marcela Torralba Espiritu | Dentist | 7540 Orangethorpe Ave, C4, Buena Park, CA 90620 | 2007-03-23 |
| 1508924457 | Randall Tay Kanemaki | Dentist | 8751 Valley View Street, Suite B, Buena Park, CA 90620 | 2006-12-04 |
| 1346338282 | J and P Homes Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6891 San Pedro Circle, Buena Park, CA 90620 | 2006-10-10 |
| Find all providers in zip 90620 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457996035 | Sean Bp Sunyoto Dds Inc | Clinic/Center | 7490 Orangethorpe Ave, Buena Park, CA 90621-3315 | 2019-11-07 |
| 1407347495 | Yun Ju Choi Dds Inc | Clinic/Center | 7700 Orangethorpe Ave Ste 2, Buena Park, CA 90621-3452 | 2018-05-24 |
| 1598019036 | Dr. A. Chang Dds, Inc | Clinic/Center | 6850 Lincoln Ave Ste 101, Buena Park, CA 90620-4179 | 2012-11-06 |
| 1215557376 | Quynh Ngo Dmd Inc | Clinic/Center | 7990 Orangethorpe Ave, Buena Park, CA 90621-3437 | 2020-04-19 |
| 1194280545 | Oliver S. Cruz, Dds, Inc. | Clinic/Center | 5825 Lincoln Ave Ste H, Buena Park, CA 90620-3477 | 2019-02-08 |
| 1205305992 | Heungki Min Dds A Professional Corp | Clinic/Center | 5881 Beach Blvd, Buena Park, CA 90621-2021 | 2018-11-26 |
| 1225397409 | St. Jude Neighborhood Health Centers | Clinic/Center | 7758 Knott Ave, Buena Park, CA 90620-2420 | 2012-05-09 |
| 1902052194 | Sunki Rhee, Dds, Inc. | Clinic/Center | 5480 Beach Blvd, Buena Park, CA 90621-1234 | 2008-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1316547524 | Ingersoll Park Marina Gp Dental Corporation | Clinic/Center | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
| Find all providers with the same taxonomy | ||||
| City | BUENA PARK |
| Zip Code | 90620 |
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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.