YOUR GREAT SMILE,INC. A DENTAL HYGIENE PRACTICE OF VANGE LEONIS, RDHAP (NPI# 1679072417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679072417 |
| Entity Type | Organization |
| Organization Name | YOUR GREAT SMILE,INC. A DENTAL HYGIENE PRACTICE OF VANGE LEONIS, RDHAP |
| Practice Address |
900 Saint Andrews Dr Rio Vista CA 94571-9707 |
| Mailing Address |
926a Diablo Ave # 122 Novato CA 94947-4025 |
| Practice Telephone | 4158987390 |
| Practice Fax Number | 4158987389 |
| Mailing Telephone | 4158987390 |
| Mailing Fax Number | 4158987389 |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |
| Authorized Official Name | VANGE IRENE LEONIS (PRESIDENT) |
| Authorized Official Telephone | 4158987390 |
| Authorized Official Credential | RDHAP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
HAP47 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1841355401 | 05 |
| Street Address |
900 SAINT ANDREWS DR |
| City | RIO VISTA |
| State | CA |
| Zip Code | 94571-9707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871060087 | Kenneth Alan Wudel | Pharmacist | 407 Main St. Delta Pharmacy, Rio Vista, CA 94571 | 2018-10-25 |
| 1366960882 | Amber Huizenga | Student in an Organized Health Care Education/Training Program | 628 Montezuma Street, Rio Vista, CA 94571 | 2017-09-05 |
| 1598195315 | Paul Willem Bolle | Marriage & Family Therapist | 125 Sacramento Street, Rio Vista, CA 94571 | 2013-11-14 |
| 1023294410 | Gwen Cotter | Counselor | 393 Del Monte Drive, Rio Vista, CA 94571 | 2008-01-15 |
| 1891758629 | Raymond Wayne Donovan Jr. | Family Medicine | 417 Eagle Crest Way, Rio Vista, CA 94571 | 2006-04-11 |
| 1598277923 | Cynthia Ann Keith | Pharmacist | 407 Main St, Rio Vista, CA 94571 | 2017-10-25 |
| 1740898808 | Maribel Torres | Pharmacist | 310 Chardonnay Way, Rio Vista, CA 94571-1108 | 2020-07-15 |
| 1730390105 | Healthy Partnerships | Community/Behavioral Health | 1105 Airport Rd Ste A, Rio Vista, CA 94571-1267 | 2007-05-25 |
| 1033636287 | Briana Soladay | Psychologist | 501 Elm Way, Rio Vista, CA 94571-1303 | 2017-08-28 |
| 1649312174 | Delta Drug Company Inc | Pharmacy | 407 Main St, Rio Vista, CA 94571-1616 | 2007-02-12 |
| Find all providers in zip 94571 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093551 | Arshdeep Kaur Dental Corporation | Clinic/Center | 345 F St Ste 180, Chula Vista, CA 91910-2648 | 2020-11-08 |
| 1699376350 | Funto Ayanleke Dds | Clinic/Center | 1116 W Tokay St Ste A, Lodi, CA 95240-3852 | 2020-11-07 |
| 1427658541 | Anthony Ngo, Dmd Professional Corporation | Clinic/Center | 18361 Beach Blvd, Huntington Beach, CA 92648-1310 | 2020-10-28 |
| 1912507948 | Alexander Phillips Dds Inc | Clinic/Center | 120 C Ave Ste 100, Coronado, CA 92118-1992 | 2020-10-28 |
| 1912507203 | George K Nguyen Dds, PC | Clinic/Center | 2097 Compton Ave Ste 104, Corona, CA 92881-7289 | 2020-10-27 |
| 1316547524 | Ingersoll Park Marina Gp Dental Corporation | Clinic/Center | 2301 Park Marina Dr Ste 27, Redding, CA 96001-2158 | 2020-10-27 |
| 1396344073 | Charles Kim Dental Corporation | Clinic/Center | 15651 Imperial Hwy Ste 204, La Mirada, CA 90638-1653 | 2020-10-22 |
| 1104425131 | Hossein Malakooti A Dental Corporation | Clinic/Center | 16540 Merrill Ave, Fontana, CA 92335 | 2020-10-21 |
| 1760081129 | Anthony Pham Dental Corp | Clinic/Center | 2658 E Garvey Ave S, West Covina, CA 91791-2113 | 2020-10-17 |
| 1215535182 | Park and Park Dental Group Partnership | Clinic/Center | 473 E Alessandro Blvd Ste A, Riverside, CA 92508-6021 | 2020-10-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on YOUR GREAT SMILE,INC. A DENTAL HYGIENE PRACTICE OF VANGE LEONIS, RDHAP.
| 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.