MISSION DENTAL (NPI# 1689066516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689066516 |
| Entity Type | Organization |
| Organization Name | MISSION DENTAL |
| Practice Address |
1166 Broadway Ste J Placerville CA 95667-5754 |
| Mailing Address |
Po Box 1043 Placerville CA 95667-1043 |
| Practice Telephone | 5306268626 |
| Mailing Telephone | 5306268626 |
| Enumeration Date | 2015-03-02 |
| Last Update Date | 2015-08-06 |
| Authorized Official Name | MS. JULIE ANN DAY (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 9168377174 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MISSION DENTAL | 312 Guilbeau Rd Ste 6b, Lafayette, LA 70506-6954 |
| Oregon Corporations, Companies and Business Names | MISSION DENTAL FOUNDATION, INC. | 125 S Elliott Rd, Newberg, OR 97132 |
| Virginia Business Entities | Mission Dental Virginia Inc. | 15325 Lee Hwy, Bristol, Virginia 24202-4013 |
| Oregon Corporations, Companies and Business Names | MISSION DENTAL, LLC | 1680 Chambers St Ste 205, Eugene, OR 97402 |
| Street Address |
1166 BROADWAY STE J |
| City | PLACERVILLE |
| State | CA |
| Zip Code | 95667-5754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053919258 | Lacey Etienne Neufeld | Nurse Practitioner | Marshall Transitional Care Unit, 1100 Marshall Way, Placerville, CA 95667 | 2020-10-12 |
| 1497390041 | Summitview Child & Family Services, Inc. | Community Based Residential Treatment Facility, Mental Illness | 3025 Glee Ln, Placerville, CA 95667 | 2019-11-07 |
| 1225694474 | Camille Borba | Doula | 1212 Lotus Rd, Placerville, CA 95667 | 2019-05-14 |
| 1033610399 | Julie Marie Halsall | Counselor | 2844 Coloma Street, Placerville, CA 95667 | 2018-02-22 |
| 1053839092 | County of El Dorado | Community/Behavioral Health | 3057 Briw Road, Suite A, Placerville, CA 95667 | 2017-08-30 |
| 1982129508 | Brent Charles Ulrici | Counselor | 2986 Colma St, Placerville, CA 95667 | 2017-08-04 |
| 1629464326 | Crystal Coury | Counselor | 5607 Mount Murphy Roas, Garden Valley, CA 95667 | 2015-04-09 |
| 1396141750 | Brown and Ghazal Dental Corporation | Dentist | 3967 Missouri Flat Road, Suite 120, Placerville, CA 95667 | 2014-11-13 |
| 1962808402 | Laura Ann Curry | Counselor | 6765 Green Valley Road, Placerville, CA 95667 | 2014-11-11 |
| 1518374453 | Kelly Lynn Carson | Counselor | 2844 Colona St., Placerville, CA 95667 | 2014-07-11 |
| Find all providers in zip 95667 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568919660 | Sheetal S Padval | Dentist | 941 Spring St Ste 6, Placerville, CA 95667-4546 | 2016-09-06 |
| 1396141750 | Brown and Ghazal Dental Corporation | Dentist | 3967 Missouri Flat Road, Suite 120, Placerville, CA 95667 | 2014-11-13 |
| 1932406824 | Patricia Sue Raymes | Dentist | 5465 Merchant Cir Ste 3, Placerville, CA 95667-8295 | 2011-02-11 |
| 1538381850 | James Haven Hastings | Dentist | 2916 Tunnel St, Placerville, CA 95667-4562 | 2007-05-03 |
| 1396872917 | Richard Dennis Whitaker | Dentist | 2825 Easy St, Placerville, CA 95667-3906 | 2007-02-28 |
| 1598829376 | Richard W Kiholm | Dentist | 3152 Gilmore St, Placerville, CA 95667-5500 | 2006-12-19 |
| 1902994171 | Steven Kent Kirkpatrick | Dentist | 708 Main St, Placerville, CA 95667-5718 | 2006-10-11 |
| 1891893905 | Ernest Spiers Watson | Dentist | 941 Spring St, Suite 6, Placerville, CA 95667-4546 | 2006-09-20 |
| 1154429967 | Russell Scott Jones | Dentist | 6390 Runnymeade Dr, Suite A, Placerville, CA 95667-8634 | 2006-09-20 |
| 1023116167 | Carl M Hillendahl, D.d.s., Inc. | Dentist | 4369 Golden Center Dr, Suite B, Placerville, CA 95667-6260 | 2006-09-20 |
| Find all providers in PLACERVILLE | ||||
| City | PLACERVILLE |
| Zip Code | 95667 |
Please comment or provide details below to improve the information on MISSION DENTAL.
| 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.