ACREE-ISENHOWER DENTAL COPORATION (NPI# 1427021757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427021757 |
| Entity Type | Organization |
| Organization Name | ACREE-ISENHOWER DENTAL COPORATION |
| Other Organization Name | FIRST SMILES CHILDREN'S DENTISTRY |
| Practice Address |
1801 Tully Road Suite B Modesto CA 95350 |
| Practice Telephone | 2093433500 |
| Practice Fax Number | 2095271971 |
| Mailing Telephone | 2093433500 |
| Mailing Fax Number | 2095271971 |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2020-08-05 |
| Authorized Official Name | MR. COREY ROBERT ACREE (PRESIDENT) |
| Authorized Official Telephone | 2095290674 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
48870 | CA | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
48880 | CA | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | DENTAL LICENSE | 20789 | 01 |
| Other Name | Type Code |
|---|---|
| First Smiles Children's Dentistry | Doing Business As Name - Organization |
| Street Address |
1801 TULLY ROAD SUITE B |
| City | MODESTO |
| State | CA |
| Zip Code | 95350 |
| 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 | 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 |
|---|---|---|---|---|
| 1396360384 | Drs Salem and Soliman Dental Corp | Dentist | 2119 E Hatch Rd Ste Bandc, Modesto, CA 95351-4814 | 2020-06-15 |
| 1730742701 | Lance C. Bautista Dds, Inc. | Dentist | 1213 Coffee Rd Ste E, Modesto, CA 95355-4229 | 2019-04-16 |
| 1861689408 | Ramin Maher | Dentist | 3219 Mchenry Ave Ste C, Modesto, CA 95350-1457 | 2007-09-27 |
| 1093847121 | Andrew Phillip Soderstrom | Dentist | 1605 Timothy Ave, Suite B, Modesto, CA 95350-4419 | 2007-03-12 |
| 1669563607 | Natalie A. Lenser | Dentist | 3109 Coffee Rd Ste B, Modesto, CA 95355-1733 | 2006-09-27 |
| 1316948870 | Robert J. Venn IIi | Dentist | 4213 Dale Rd, B6, Modesto, CA 95356-8505 | 2005-08-09 |
| 1063890689 | Behrouz Sami, Dmd, Inc | Dentist | 556 Lyell Dr, Modesto, CA 95356-8970 | 2015-05-14 |
| 1578706636 | Behrouz Sami Daryani | Dentist | 556 Lyell Dr, Modesto, CA 95356-8970 | 2009-04-19 |
| 1588704951 | Lance Bautista | Dentist | 1213 Coffee Rd, Modesto, CA 95355-4229 | 2007-02-07 |
| 1891801502 | David Gene Bauman | Dentist | 1213 Coffee Rd, Suite G, Modesto, CA 95355-4229 | 2006-08-23 |
| 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.