CAPITOL PERIODONTAL GROUP (NPI# 1366908618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366908618 |
| Entity Type | Organization |
| Organization Name | CAPITOL PERIODONTAL GROUP |
| Practice Address |
750 F Street #5 Davis CA 95616 |
| Mailing Address |
9309 Office Park Circle, Suite 120 Elk Grove CA 95758 |
| Practice Telephone | 5307566087 |
| Practice Fax Number | 5307565688 |
| Mailing Telephone | 9166911050 |
| Mailing Fax Number | 9166911066 |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | RENEE BLAKE (INSURANCE COORDINATOR) |
| Authorized Official Telephone | 9166911050 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962735993 | Capitol Periodontal Group | Dentist | 2535 E Bidwell St Ste 150, Folsom, CA 95630-6458 | 2009-09-09 |
| 1063604684 | Capitol Periodontal Group | Dentist | 9309 Office Park Cir, Ste 110, Elk Grove, CA 95758-8072 | 2007-08-16 |
| 1235321852 | Capitol Periodontal Group | Dentist | 2428 Professional Dr, Ste 100, Roseville, CA 95661-7774 | 2007-08-16 |
| Street Address |
750 F STREET #5 |
| City | DAVIS |
| State | CA |
| Zip Code | 95616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560871 | Anne-frances Ostrander | Physical Therapy Assistant | 397 La Rue Rd, Davis, CA 95616 | 2020-08-26 |
| 1487271458 | Alix Peloso Mahon | Behavior Technician | 1212 Alvarado Ave Apt 68, Davis, CA 95616 | 2020-06-25 |
| 1427671882 | Dhhs Ihs Cao Sacred Oaks Healing Center | Substance Abuse Rehabilitation Facility | 33100 County Road 31, Davis, CA 95616 | 2020-05-20 |
| 1871126961 | Linda Marie Adams | Dietitian, Registered | Uc Davis Occupational Health, One Shields Ave - Cowell Hall Room 35, Davis, CA 95616 | 2020-02-17 |
| 1851935217 | Timothy James Johnston | Orthotist | 635 Anderson Rd., Suite 18, Davis, CA 95616 | 2019-10-29 |
| 1386290716 | Dakota Cool | Specialist/Technologist | 750 Orchard Road, Davis, CA 95616 | 2019-08-12 |
| 1831663434 | Elisha Niccole Cusumano | Specialist/Technologist | 264 Hickey Gym, 1 Shields Ave, Davis, CA 95616 | 2019-01-16 |
| 1609364991 | Aron Matthew Katz | Psychologist | One Shield Ave, Student Health & Wellness Center, Bhp, Davis, CA 95616 | 2018-04-23 |
| 1316463938 | Arielle Pinkston | Marriage & Family Therapist | 203 F St, Davis, CA 95616 | 2017-08-15 |
| 1578092854 | Shannon Chris Ram | Dentist | 1621 Oak Avenue, Suite A, Davis, CA 95616 | 2017-06-08 |
| Find all providers in zip 95616 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518081439 | Hamid R Shirazi | Dentist | 750 F St Ste 5, Davis, CA 95616-3738 | 2007-03-17 |
| 1922003185 | David L. Jolkovsky | Dentist | 1205 Drake Dr, Ste B, Davis, CA 95616-0856 | 2005-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982204780 | Richard Koh Dds Ms Inc. | Dentist | 11 Delano, Irvine, CA 92602-2462 | 2020-10-30 |
| 1225641293 | Richard T. Kao, Dds, Phd - Dental Corp. | Dentist | 1660 Willow St Ste 3, San Jose, CA 95125-5101 | 2020-08-28 |
| 1093325722 | Sergio Florencio Jr, Dds, Dmsc, Inc | Dentist | 1802 San Miguel Dr, Walnut Creek, CA 94596-8606 | 2020-08-06 |
| 1205463445 | Sharona Dayan, Dds, Inc | Dentist | 9735 Wilshire Blvd Ste 211, Beverly Hills, CA 90212-2102 | 2020-03-26 |
| 1215573522 | Vanessa Bikhazi | Dentist | 2372 Se Bristol St Ste A, Newport Beach, CA 92660-0755 | 2019-11-21 |
| 1063057008 | Robert Lacrampe | Dentist | 880 W 1st St Apt 526, Los Angeles, CA 90012-2473 | 2019-11-13 |
| 1376194639 | Snow Nakano & Lopez Professional Dental Corporation | Dentist | 868 Auto Center Dr Ste A, Palmdale, CA 93551-4691 | 2019-09-26 |
| 1659926285 | Suman Ramakumar Dds Inc | Dentist | 1171 Homestead Rd Ste 175, Santa Clara, CA 95050-5484 | 2019-08-09 |
| 1912567058 | Andrew Peterson Dmd Ms PC | Dentist | 9856 Hibiscus Ct, Alta Loma, CA 91737-3637 | 2019-06-20 |
| 1124686233 | Danoukh Dental Corp. | Dentist | 12271 La Mirada Blvd Ste 201, La Mirada, CA 90638-1336 | 2019-06-04 |
| Find all providers with the same taxonomy | ||||
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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.