COUNTY OF SANTA CLARA (NPI# 1578642872) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578642872 |
| Entity Type | Organization |
| Organization Name | COUNTY OF SANTA CLARA |
| Other Organization Name | TULLY MOBILE DENTAL UNIT |
| Practice Address |
500 Tully Rd Tully Dental Mobile Unit San Jose CA 95111-1917 |
| Mailing Address |
Po Box 5280 Patient Business Services San Jose CA 95150-5280 |
| Practice Telephone | 4088855000 |
| Mailing Telephone | 4088855000 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. ALFONSO F BANUELOS JR. (CHIEF MEDICAL OFFICER) |
| Authorized Official Telephone | 4088854001 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QD0000X |
Clinic/Center Specialization: Dental |
CA | Ambulatory Health Care Facilities | |
| X | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC80070F | 05 |
| Other Name | Type Code |
|---|---|
| Tully Mobile Dental Unit | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578082400 | County of Santa Clara | Clinic/Center | 2101 Alexian Dr., Vhc At Alexian, San Jose, CA 95116-1901 | 2017-09-12 |
| 1073052734 | County of Santa Clara | Community/Behavioral Health | 4825 Speak Ln, San Jose, CA 95118-3769 | 2017-02-14 |
| 1306204342 | County of Santa Clara | Psychiatric Unit | 820 Enborg Court, San Jose, CA 95128 | 2016-02-05 |
| 1447645296 | County of Santa Clara | Clinic/Center | 777 E. Santa Clara St, Vhc At Downtown, San Jose, CA 95112 | 2015-03-30 |
| 1508269853 | County of Santa Clara | Community/Behavioral Health | 591 N King Rd Ste 1, San Jose, CA 95133-1661 | 2014-10-01 |
| 1053713958 | County of Santa Clara | Community/Behavioral Health | 2650 Senter Rd, San Jose, CA 95111-1121 | 2014-09-23 |
| 1508296526 | County of Santa Clara | Community/Behavioral Health | 850 Day Rd, Gilroy, CA 95020-9324 | 2013-11-13 |
| 1205275252 | County of Santa Clara | Community/Behavioral Health | 85 Tilton Ave, Morgan Hill, CA 95037-2504 | 2013-06-21 |
| 1316265226 | County of Santa Clara | Clinic/Center | 143 North Main Street, Milpitas, CA 95035-5302 | 2010-05-17 |
| 1083875074 | County of Santa Clara | Clinic/Center | 2221 Enborg Ln Ste 200, San Jose, CA 95128-2608 | 2008-06-23 |
| Street Address |
500 TULLY RD TULLY DENTAL MOBILE UNIT |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95111-1917 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467992040 | Margarita Teresa Rodriguez | Technician, Other | 500 Tully Rd, San Jose, CA 95111-1917 | 2017-03-02 |
| 1093116634 | Ken Miyazato | Dentist | 500 Tully Rd, San Jose, CA 95111-1917 | 2014-09-15 |
| 1639508195 | Monilola M Layokun | Nurse Practitioner | 500 Tully Rd, San Jose, CA 95111-1917 | 2013-11-05 |
| 1396008470 | Chaoyu Kawamura | Pharmacist | 500 Tully Rd, San Jose, CA 95111-1917 | 2012-06-22 |
| 1013270727 | Lisa Nguyen | Pharmacist | 500 Tully Rd, San Jose, CA 95111-1917 | 2012-06-18 |
| 1245593953 | Anhdai Nguyen | Pharmacist | 500 Tully Rd, San Jose, CA 95111-1917 | 2012-06-18 |
| 1184986275 | Bao-chau Crystal Bui | Pharmacist | 500 Tully Rd, San Jose, CA 95111-1917 | 2012-06-13 |
| 1851683288 | Maryann Abiodun Pitts | Pediatrics | 500 Tully Rd, San Jose, CA 95111-1917 | 2011-05-03 |
| 1417284746 | Marina Wasche | Dentist | 500 Tully Rd, 2nd Floor Dental Clinic, San Jose, CA 95111-1917 | 2009-11-06 |
| 1316124951 | County of Santa Clara | Clinic/Center | 500 Tully Rd, San Jose, CA 95111-1917 | 2008-01-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134667413 | Aldo Hernandez | Community Health Worker | 488 Skyway Dr, San Jose, CA 95111 | 2017-02-07 |
| 1518217017 | Jean Jennifer J Soliven | Registered Nurse | 614 Tully Rd., San Jose, CA 95111 | 2012-09-12 |
| 1679894604 | Julie Chi | Counselor | 581 Coyote Road, San Jose, CA 95111 | 2010-06-14 |
| 1720278179 | Mv Transportation | Non-emergency Medical Transport (VAN) | 555 Tully Road, Mv Transportation, San Jose, CA 95111 | 2007-07-31 |
| 1437355948 | Anthony Cozzolino | Psychiatry & Neurology | 614 Tully Road, Narvaez Mental Health, San Jose, CA 95111 | 2007-06-22 |
| 1750403515 | Karen Pham | Dentist | 4074 Monterey Road, San Jose, CA 95111 | 2007-04-04 |
| 1376697847 | Mai Anh Le | Dentist | 60 Senter Rd, San Jose, CA 95111 | 2007-01-22 |
| 1649335852 | Bui and Enriquez Dental Corporation | Dentist | 485 Lewis Rd, Suite A, San Jose, CA 95111 | 2006-12-27 |
| 1619031903 | Huyen Thu Nguyen | Pharmacist | 796 Apple Terrace, San Jose, CA 95111 | 2006-12-20 |
| 1285720342 | Lily Khanh-linh Thi Nguyen | Obstetrics & Gynecology | 500 W Tully Rd, Ob/gyn Clinic, San Jose, CA 95111 | 2006-10-05 |
| Find all providers in zip 95111 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033750195 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 5253 Prospect Rd Ste D-2, San Jose, CA 95129-5025 | 2019-09-30 |
| 1295203941 | Dr. Jacqueline B. Nguyen, Dds, Apc | Clinic/Center | 2847 S White Rd Ste 204, San Jose, CA 95148-2942 | 2018-11-09 |
| 1326521055 | Rachana Vyas Dds Inc | Clinic/Center | 5150 Graves Ave Ste 5c, San Jose, CA 95129-5005 | 2018-09-10 |
| 1821570102 | Lori Chung Cho Dmd Inc. | Clinic/Center | 150 N Jackson Ave Ste 103, San Jose, CA 95116 | 2018-09-03 |
| 1750860912 | Cory A. Timbers, Dds, Inc. | Clinic/Center | 155 N Jackson Ave Ste 202, San Jose, CA 95116-1925 | 2018-08-08 |
| 1730675109 | Healing Property LLC | Clinic/Center | 2211 Moorpark Ave Ste 100, San Jose, CA 95128-2655 | 2018-07-09 |
| 1225524226 | Young Dental Corporation | Clinic/Center | 1705 Branham Ln Ste B4, San Jose, CA 95118-5222 | 2018-07-03 |
| 1902399637 | Changndds, Inc | Clinic/Center | 3161 Senter Rd Ste F&g, San Jose, CA 95111-1300 | 2018-06-07 |
| 1861981813 | Rachna Pall D.d.s Inc. | Clinic/Center | 2323 Montpelier Dr Ste B, San Jose, CA 95116-1611 | 2018-05-05 |
| 1194212464 | Thao Minh Nguyen, Dds, Inc | Clinic/Center | 2811 Story Rd Ste 50, San Jose, CA 95127-3924 | 2018-04-22 |
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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.