PACIFIC PEDIATRIC DENTISTRY (NPI# 1144739715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144739715 |
| Entity Type | Organization |
| Organization Name | PACIFIC PEDIATRIC DENTISTRY |
| Practice Address |
1231 Osos St San Luis Obispo CA 93401-3619 |
| Practice Telephone | (805) 544-3434 |
| Practice Fax Number | 8055443443 |
| Mailing Telephone | 8055443434 |
| Mailing Fax Number | 8055443443 |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2017-09-26 |
| Authorized Official Name | DR. EUN HA YOU (OWNER) |
| Authorized Official Telephone | 8055443434 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
54656 | CA | Dental Providers |
| Street Address |
1231 OSOS ST |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-3619 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679670277 | Larry V Smith | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2006-09-19 |
| 1750585121 | Eunha You | Dentist | 1231 Osos St, San Luis Obispo, CA 93401-3619 | 2007-06-12 |
| 1457485583 | Larry V Smith Dds Inc | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2007-03-14 |
| 1134252489 | T Dean Walker Dds Ms Inc | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2007-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| 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 |
|---|---|---|---|---|
| 1295139590 | Tolosa Childrens Dental Center | Dentist | 4251 S Higuera St Ste 401, San Luis Obispo, CA 93401-7714 | 2014-10-15 |
| 1952553091 | Jac W Pedersen II | Dentist | 3221 S Higuera St, Ste. 100, San Luis Obispo, CA 93401-6924 | 2008-10-21 |
| 1407014541 | Jac W Pedersen II Dds | Dentist | 3221 S Higuera St Ste 100, San Luis Obispo, CA 93401-6924 | 2008-05-27 |
| 1194803049 | Jac W. Pedersen II, D.d.s., Inc | Dentist | 620 California Blvd Ste H, San Luis Obispo, CA 93401-2500 | 2006-11-01 |
| 1679670277 | Larry V Smith | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2006-09-19 |
| 1386032407 | Vikram R. Tiku, Dds, Inc. | Dentist | 3221 S Higuera St, San Luis Obispo, CA 93401-6924 | 2014-12-23 |
| 1790127173 | Newsom Forester Dental Partnership | Dentist | 620 California Blvd, Suite G, San Luis Obispo, CA 93401-2541 | 2013-07-25 |
| 1427304294 | Vikram Raj Tiku | Dentist | 3221 S Higuera St, San Luis Obispo, CA 93401-6924 | 2012-07-31 |
| 1457485583 | Larry V Smith Dds Inc | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2007-03-14 |
| 1134252489 | T Dean Walker Dds Ms Inc | Dentist | 1231 Osos St, San Luis Obispo, CA 93401 | 2007-03-14 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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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.