CENTRAL COAST PEDIATRIC DENTAL GROUP (NPI# 1205922705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205922705 |
| Entity Type | Organization |
| Organization Name | CENTRAL COAST PEDIATRIC DENTAL GROUP |
| Practice Address |
631 E Alvin Drive Suite B Salinas CA 93906 |
| Mailing Address |
631 E Alvin Drive Suite C Salinas CA 93906 |
| Practice Telephone | 8314431177 |
| Practice Fax Number | 8314430705 |
| Mailing Telephone | 8314428878 |
| Mailing Fax Number | 8314434611 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2012-06-12 |
| Authorized Official Name | MRS. ANNA M LIZAOLA (ADMINISTRATIVE ASSISTANT) |
| Authorized Official Telephone | 8314428878 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
37400 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | G9087502 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942333059 | Central Coast Pediatric Dental Group | Dentist | 1717 Fremont Blvd, Seaside, CA 93955 | 2007-03-14 |
| 1033242144 | Central Coast Pediatric Dental Group | Dentist | 945 Blanco Circle Suite D, Salinas, CA 93901 | 2007-03-14 |
| Street Address |
631 E ALVIN DRIVE SUITE B |
| City | SALINAS |
| State | CA |
| Zip Code | 93906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477649960 | Ray Edward Stewart | Dentist | 631 E Alvin Drive, Suite B, Salinas, CA 93096 | 2006-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618883 | Casandra Andrea Gonzales | Case Manager/Care Coordinator | 1441 Constitution Blvd Building 400 Suite 202, Salinas, CA 93906 | 2020-08-05 |
| 1033730734 | Georgina Rodriguez | Behavioral Analyst | 1441 Constituion Blvd Bldg 400, Suite 202, Salinas, CA 93906 | 2020-05-04 |
| 1083252589 | Diane M Cassam | Marriage & Family Therapist | 1441 Constitution Blvd., Bldg. 400, Suite 200, Salinas, CA 93906 | 2019-12-16 |
| 1558849349 | Heather Lynne Rogers | Counselor | 1441 Constitution Blvd., Bldg. 400, Ste 202, Salinas, CA 93906 | 2018-08-02 |
| 1053897462 | Mayra Lizeth Barocio | Counselor | 1441 Constitution Blvd Bldg 4002, Salinas, CA 93906 | 2018-07-18 |
| 1720571425 | Ashley A Rangel | Behavior Technician | 1123 Baldwin St., Salinas, CA 93906 | 2018-06-07 |
| 1013419597 | Sean Crow | Behavior Technician | 1123 Baldwin, Salinas, CA 93906 | 2018-03-01 |
| 1942720164 | Joshua Lawrence Deutsch | Student in an Organized Health Care Education/Training Program | 1441 Constutution Blvd, Blg 400, Third Floor, Salinas, CA 93906 | 2017-06-20 |
| 1679014450 | Chris Moreno | Counselor | 1127 Baldwin St., Suite A, Salinas, CA 93906 | 2017-03-14 |
| 1295101657 | Craig Varjian | Dentist | 640 E. Alvin Drive, Suite D, Salinas, CA 93906 | 2015-08-19 |
| Find all providers in zip 93906 | ||||
| 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 |
|---|---|---|---|---|
| 1457770059 | Jacqueline Nguyen | Dentist | 945 Blanco Cir Ste D, Salinas, CA 93901-4421 | 2014-04-10 |
| 1033242144 | Central Coast Pediatric Dental Group | Dentist | 945 Blanco Circle Suite D, Salinas, CA 93901 | 2007-03-14 |
| 1477649960 | Ray Edward Stewart | Dentist | 631 E Alvin Drive, Suite B, Salinas, CA 93096 | 2006-10-04 |
| 1952497448 | Marielena Murillo | Dentist | 633 E Alvin Drive, Suite B, Salinas, CA 93906 | 2006-10-04 |
| 1669568168 | Paul J Morris | Dentist | 633 E Alvin Dr Suite B, Salinas, CA 93906 | 2006-10-04 |
| 1487740973 | Charles Edwin Sackett Iv | Dentist | 633 E Alvin Drive Ste B, Salinas, CA 93906 | 2006-10-04 |
| 1255627592 | Jennifer Lo | Dentist | 1045 Los Palos Dr, Salinas, CA 93901-3916 | 2011-06-24 |
| 1598085078 | Pooja Rattan | Dentist | 631 E Alvin Dr, Suite C, Salinas, CA 93906-3056 | 2010-06-07 |
| 1457481525 | Seth L Reder | Dentist | 631 E Alvin Dr, Suite E, Salinas, CA 93906-3056 | 2007-03-06 |
| 1063596815 | Jennifer D Morris | Dentist | 631 E Alvin Dr Suite B, Salinas, CA 93906 | 2006-10-25 |
| Find all providers in SALINAS | ||||
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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.