MANJEET SAMRA DENTAL CORPORATION (NPI# 1144832221) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144832221 |
| Entity Type | Organization |
| Organization Name | MANJEET SAMRA DENTAL CORPORATION |
| Practice Address |
1700 Mchenry Ave Ste 16b Modesto CA 95350-4319 |
| Mailing Address |
1110 W Robinhood Dr Stockton CA 95207-5606 |
| Practice Telephone | 2099233013 |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2020-08-19 |
| Authorized Official Name | DR. MANJEET SAMRA (OWNER) |
| Authorized Official Telephone | 2099233013 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LOCATION | 1 | 01 |
| Other Name | Type Code |
|---|---|
| Samra Orthodontics | Doing Business As Name - Organization |
| Street Address |
1700 MCHENRY AVE STE 16B |
| City | MODESTO |
| State | CA |
| Zip Code | 95350-4319 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020459 | Karina Montes Rodriguez | Case Manager/Care Coordinator | Cip 1540 Florida Ave, Suite 212, Modesto, CA 95350 | 2020-10-09 |
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1588211254 | Karla Junuen Toscano | Licensed Vocational Nurse | 1235 Mchenry Ave. Suites A&b, Modesto, CA 95350 | 2019-08-19 |
| 1831694769 | Loretta Myers-weber | Nurse Practitioner | 1510 Florida Ave Ste A, Modesto, CA 95350 | 2018-03-23 |
| 1720599632 | Coral Alejandra Amador | Counselor | 1700 Mchenry Village Way, Suite 11b, Modesto, CA 95350 | 2017-10-18 |
| 1053820522 | Pannu and Henne Dental Corp. | Dentist | 3219 Mc Henry Ave, Suite E, Modesto, CA 95350 | 2017-09-27 |
| 1346779709 | Kevin Sotelo | Behavior Technician | 2630 W Rumble Road, Modesto, CA 95350 | 2017-06-08 |
| 1255869566 | Hoa Xuan Phan | Family Medicine | 1441 Florida Ave Ste 200, Modesto, CA 95350 | 2017-05-31 |
| 1356881163 | Brady S Marshall | Dentist | 201 E. Orangeburg Avenue, Suite C, Modesto, CA 95350 | 2017-02-27 |
| 1750755476 | Caremore Health Plan | Nurse Practitioner | 1234 Mchenry Avenue, Modesto, CA 95350 | 2015-11-18 |
| Find all providers in zip 95350 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134737315 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 2057 Tully Road, Suite A, Modesto, CA 95350 | 2020-07-14 |
| 1659541647 | Ashley Allison Streeter | Dentist | 556 Lyell Dr, Modesto, CA 95356 | 2008-03-05 |
| 1114195401 | Jeffrey Darren Barton | Dentist | 2501 E Hatch Rd, Modesto, CA 95351-4817 | 2008-02-20 |
| 1366626764 | Jeremy Thomas West | Dentist | 1500 Mchenry Ave, Modesto, CA 95350-4529 | 2007-12-20 |
| 1932380201 | Amy Elaine Buchler | Dentist | 1236 Floyd Ave Ste C, Modesto, CA 95350-2472 | 2007-11-15 |
| 1659592285 | Matthew D Swatman | Dentist | 400 E. Orangeburg Avenue, Suite 3, Modesto, CA 95350 | 2007-05-01 |
| 1104044312 | Ronald Lynn Champion | Dentist | 4101 Tully Rd Ste 401, Modesto, CA 95356-8982 | 2007-04-23 |
| 1720204332 | Stan R Heiner | Dentist | 1540 Oakdale Rd, Modesto, CA 95355-3306 | 2007-04-18 |
| 1811024227 | Sam Paregian | Dentist | 1601 Mchenry Village Wy, #8, Modesto, CA 95350 | 2007-02-27 |
| 1972630887 | Scott R. Asbill | Dentist | 1524 Mchenry Ave Ste 535, Modesto, CA 95350-4572 | 2007-02-27 |
| Find all providers in MODESTO | ||||
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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.