MACT HEALTH BOARD, INC. (NPI# 1528508488) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528508488 |
| Entity Type | Organization |
| Organization Name | MACT HEALTH BOARD, INC. |
| Practice Address |
1113a Highway 49 San Andreas CA 95249 |
| Mailing Address |
Po Box 939 Angels Camp CA 95222-0939 |
| Practice Telephone | 2097551460 |
| Mailing Telephone | 2097546262 |
| Enumeration Date | 2017-02-27 |
| Last Update Date | 2017-02-27 |
| Authorized Official Name | JOHN ALEXANDER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2097546258 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | Eye and Vision Services Providers | ||
| Y | 122300000X | Dentist | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417505918 | Mact Health Board, Inc. | Dentist | 52 S Main Street, Suite B, Angels Camp, CA 95222 | 2019-08-28 |
| 1366519431 | Mact Health Board, Inc. | Clinic/Center | 1113 Highway 49, San Andreas, CA 95249 | 2006-11-30 |
| 1295727287 | Mact Health Board, Inc. | Clinic/Center | 12140/12150 New York Ranch Rd, Jackson, CA 95642-9407 | 2005-08-17 |
| 1346410255 | Mact Health Board, Inc. | Clinic/Center | 1113 Hwy 49, San Andreas, CA 95249-9583 | 2008-03-06 |
| 1740272731 | Mact Health Board, Inc. | Clinic/Center | 5192 Hospital Rd, Mariposa, CA 95338-9524 | 2005-08-17 |
| 1467444364 | Mact Health Board, Inc. | Clinic/Center | 13975 Mono Way, Suite G, H & I, Sonora, CA 95370-2824 | 2005-08-17 |
| Street Address |
1113A HIGHWAY 49 |
| City | SAN ANDREAS |
| State | CA |
| Zip Code | 95249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184265175 | Meadowmont Pharmacy Inc | Pharmacy | 45 E Saint Charles St Ste C, San Andreas, CA 95249 | 2019-10-01 |
| 1225501844 | Samantha Jolene Cooper | Marriage & Family Therapist | 23 West Saint Charles, San Andreas, CA 95249 | 2019-01-07 |
| 1063992865 | Regina Elizabeth King | Speech-Language Pathologist | 255 Lewis Avenue, San Andreas, CA 95249 | 2018-08-21 |
| 1770060113 | Hilary Rose Gambetta | Speech-Language Pathologist | 3304 Highway 12, San Andreas, CA 95249 | 2018-07-27 |
| 1548704562 | Elizabeth Thompson | Non-emergency Medical Transport (VAN) | 130 E Saint Charles St, San Andreas, CA 95249 | 2016-12-09 |
| 1952730194 | Asha Brock | Marriage & Family Therapist | 593 West Saint Charles Street, San Andreas, CA 95249 | 2013-11-07 |
| 1376897355 | Marjorie Frances Kallis | Registered Nurse | 87 East St Charles St, San Andreas, CA 95249 | 2012-10-30 |
| 1841544897 | Curtis Saxton | Durable Medical Equipment & Medical Supplies | 620 East Saint Charles St., San Andreas, CA 95249 | 2012-10-30 |
| 1962759522 | Calaveras County Behavioral Health Children | Community/Behavioral Health | 373 West St.charles Street, Suite B, San Andreas, CA 95249 | 2012-08-13 |
| 1124322953 | Joan Dionne | Social Worker | 891 Mountain Ranch Road, San Andreas, CA 95249 | 2011-01-10 |
| Find all providers in zip 95249 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487658860 | Joana Codruta Mihaila-motiu | Dentist | 40 E Saint Charles St, San Andreas, CA 95249 | 2005-06-13 |
| 1851605737 | Hee Jeong | Dentist | 372 Luddy Lane, San Andreas, CA 95249 | 2010-08-03 |
| 1083854723 | Daniel Chai Siriphongs | Dentist | 372 Luddy Lane, San Andreas, CA 95249-0400 | 2009-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447057 | Sienna Palmer Ogbevoen Dds, Inc. | Dentist | 27871 Medical Center Rd Ste 290, Mission Viejo, CA 92691-6440 | 2020-11-07 |
| 1821699737 | William Bill Ngo | Dentist | 1591 Griffin Road Mcagcc, Twentynine Palms, CA 92277 | 2020-11-06 |
| 1134720022 | Iee Shin | Dentist | 30406 Haun Rd Ste 740, Menifee, CA 92584-6816 | 2020-11-05 |
| 1568063634 | Western Dental Services, Inc. | Dentist | 2537 S Euclid Ave Ste A, Ontario, CA 91762-6620 | 2020-11-05 |
| 1467053660 | Gurjot Sidhu Dds Dental Corporation | Dentist | 2701 E Hammer Ln Ste 101, Stockton, CA 95210-4245 | 2020-11-04 |
| 1821699133 | Ayesha Ahmad | Dentist | 4910 Chapparal Way, Banning, CA 92220-3353 | 2020-11-03 |
| 1407457856 | Yiyang Zou | Dentist | 333 W El Camino Real Ste 260, Sunnyvale, CA 94087-8127 | 2020-11-03 |
| 1851992481 | Centinela Joseph Dental Group | Dentist | 6907 La Tijera Blvd, Los Angeles, CA 90045-1906 | 2020-11-02 |
| 1518568138 | Raime Shah | Dentist | 707 Parnassus Ave Ste D-3000, San Francisco, CA 94143-2210 | 2020-11-02 |
| 1558961359 | Tony Tataro | Dentist | 5700 Village Oaks Dr Apt 1222, San Jose, CA 95123-3771 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | SAN ANDREAS |
| Zip Code | 95249 |
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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.