M ELDER DENTAL GROUP CORPORATION (NPI# 1215599394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215599394 |
| Entity Type | Organization |
| Organization Name | M ELDER DENTAL GROUP CORPORATION |
| Practice Address |
704 Blossom Hill Rd Ste 102 San Jose CA 95123-5403 |
| Mailing Address |
446 Merlot Ln American Canyon CA 94503-1243 |
| Practice Telephone | 4082255000 |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2019-06-28 |
| Authorized Official Name | EMMY MONTES (DIRECTOR OF CENTRALIZED BILLING) |
| Authorized Official Telephone | 4152466305 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Street Address |
704 BLOSSOM HILL RD STE 102 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95123-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013495985 | Ned L. Nix, Dds, Inc | Oral & Maxillofacial Surgery | 704 Blossom Hill Rd Ste 102, San Jose, CA 95123-5403 | 2018-08-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700441045 | Calvin Patrick Nell | Chiropractor | 5570 Sanchez Drive, Ste 100, San Jose, CA 95123 | 2019-05-02 |
| 1629557152 | Jia Tian | Dentist | 393 Blossom Hill Rd Ste 150, San Jose, CA 95123 | 2018-08-06 |
| 1003306176 | Western Dental Services, Inc. | Dentist | 451 Blossom Hill Rd Suite 20, San Jose, CA 95123 | 2018-05-15 |
| 1871004945 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5411 Thornwood Dr, San Jose, CA 95123 | 2017-10-17 |
| 1437672953 | Mie Mie Chiu | Dietitian, Registered | 276 Palm Valley Blvd #205, San Jose, CA 95123 | 2017-07-18 |
| 1902335300 | Alfredo Fernandez | Counselor | 5898 Paddon Circle, San Jose, CA 95123 | 2017-06-08 |
| 1780115444 | Christopher Vi Tran | Case Manager/Care Coordinator | 5579 Lean Avenue, San Jose, CA 95123 | 2017-03-24 |
| 1205370004 | Linxi Wu | Acupuncturist | 6064 Cahalan Ave, San Jose, CA 95123 | 2016-12-13 |
| 1013307651 | Kevin Dizon | Dental Hygienist | 6071 Sunstone Drive, San Jose, CA 95123 | 2015-02-04 |
| 1285031294 | Katie Tran | Dental Assistant | 524 Glenburry Way, San Jose, CA 95123 | 2014-11-20 |
| Find all providers in zip 95123 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609493170 | Amir Haghshenas Dds | Dentist | 3880 S Bascom Ave Ste 213, San Jose, CA 95124-2675 | 2020-07-01 |
| 1871975888 | Andrew Harsany | Dentist | 2945 The Villages Pkwy, San Jose, CA 95135-1451 | 2015-06-25 |
| 1881981488 | Kevin Jia-chian Yen | Dentist | 1660 Willow St Ste 5, San Jose, CA 95125 | 2011-07-02 |
| 1407087083 | Brandon B. Kang | Dentist | 1655 The Alameda, San Jose, CA 95126-2203 | 2009-07-31 |
| 1427182179 | Andrew D Harsany Dds Inc | Dentist | 2945 The Villages Parkway, San Jose, CA 95135 | 2007-03-15 |
| 1548354095 | Paul Joseph Carroll | Dentist | 5460 Dellwood Way, San Jose, CA 95118 | 2006-10-02 |
| 1699886283 | Jon R Lindsay | Dentist | 2118 Mckee Rd, San Jose, CA 95116-1427 | 2006-08-31 |
| 1831211531 | Joseph Edward Kuhar | Dentist | 4110 Moorpark Ave, Suite E, San Jose, CA 95117-1712 | 2007-04-04 |
| 1619049665 | Herbert Carl Berquist | Dentist | 5150 Graves Ave, #12h, San Jose, CA 95129-5015 | 2006-11-14 |
| 1639275217 | Ned Leonard Nix | Dentist | 704 Blossom Hill Rd, Suite 102, San Jose, CA 95123-5403 | 2006-09-15 |
| Find all providers in SAN JOSE | ||||
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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.