THEODORE RIST JR. (NPI# 1295898245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295898245 |
| Entity Type | Individual |
| Full Name | THEODORE RIST JR. |
| Credential | D.D.S. |
| Practice Address |
1730 Novato Blvd Ste F Novato CA 94947-3048 |
| Practice Telephone | 4158923761 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
031850 | CA | Dental Providers |
| Street Address |
1730 NOVATO BLVD STE F |
| City | NOVATO |
| State | CA |
| Zip Code | 94947-3048 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407135882 | Rainey Sealey Temkin | Psychologist | 1682 Novato Blvd Ste 105, Novato, CA 94947 | 2011-08-16 |
| 1801192786 | Barbara Jean Gosselin | Marriage & Family Therapist | 1748 Novato Blvd Suite 210, Novato, CA 94947 | 2011-02-10 |
| 1659681377 | Karen Ann Murphy | Occupational Therapist | 27 Stasia Dr., Novato, CA 94947 | 2010-10-15 |
| 1154659415 | Christopher Michael Hackett | Chiropractor | 1559 South Novato Blvd., Suite E, Novato, CA 94947 | 2009-11-25 |
| 1003068305 | Suttinee Saguandeekul | Pharmacist | 910 Diablo Ave, Novato, CA 94947 | 2008-10-17 |
| 1891983581 | Shital Gandhi | Radiology | 500 Redwood Blvd Ste 300, Novato, CA 94947 | 2007-10-09 |
| 1356544126 | Victoria Elizabeth Herzog | Marriage & Family Therapist | 1682 Novato Blvd, Suite 250a, Novato, CA 94947 | 2007-06-07 |
| 1912047655 | Michael Craig Corder | Chiropractor | 1553 S Novato Blvd, A2 Corder Chiropractic Office, Novato, CA 94947 | 2007-02-08 |
| 1427106905 | Jacob Kyle Leone | Naturopath | 1748 Novato Blvd, Suite 100, Novato, CA 94947 | 2007-01-08 |
| 1881756401 | Mental Health Management I, Inc. | Psychiatric Residential Treatment Facility | 655 Canyon Road, Novato, CA 94947 | 2006-12-14 |
| Find all providers in zip 94947 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104311935 | Sara Kwong | Dentist | 1805 Novato Blvd Ste 4, Novato, CA 94947-2934 | 2018-06-25 |
| 1609161652 | Kulyk Dental Corporation | Dentist | 1744 Novato Blvd Ste 110, Novato, CA 94947-3092 | 2011-06-17 |
| 1477885960 | Paul Kim | Dentist | 6090 Redwood Blvd, Suite D, Novato, CA 94945-4569 | 2010-02-08 |
| 1619194834 | Jonathan Maclean | Dentist | 208 Vintage Way, Suite K23, Novato, CA 94945-5014 | 2007-04-19 |
| 1083732499 | M Paul Schafer | Dentist | 896 Sutro Ave, Novato, CA 94947-2040 | 2007-03-26 |
| 1265558332 | Norman Ivan Elloway | Dentist | 1316 Grant Ave, Novato, CA 94945-3100 | 2007-03-21 |
| 1073650578 | Matthew Menasco | Dentist | 1615 Hill Rd Ste A, Novato, CA 94947-4338 | 2007-01-31 |
| 1396812731 | Clayton Joseph Perry | Dentist | 7460 Redwood Blvd, Novato, CA 94945-2457 | 2006-11-29 |
| 1831273143 | Myron Lee Donesky | Dentist | 7250 Redwood Blvd, Suite 210, Novato, CA 94945-3268 | 2006-10-24 |
| 1154405355 | Steve L Mcconnell | Dentist | 1730 Novato Blvd Ste A, Novato, CA 94947-3048 | 2006-10-24 |
| Find all providers in NOVATO | ||||
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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.