LANCE C. BAUTISTA DDS, INC. (NPI# 1730742701) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730742701 |
Entity Type | Organization |
Organization Name | LANCE C. BAUTISTA DDS, INC. |
Practice Address |
1213 Coffee Rd Ste E Modesto CA 95355-4229 |
Practice Telephone | 2095235437 |
Practice Fax Number | 2095235436 |
Mailing Telephone | 2095235437 |
Mailing Fax Number | 2095235436 |
Enumeration Date | 2019-04-16 |
Last Update Date | 2019-04-16 |
Authorized Official Name | LANCE C. BAUTISTA (CEO, PRESIDENT) |
Authorized Official Telephone | 2095235437 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
Other Name | Type Code |
---|---|
Dr. Lance C. Bautista Pediatric Dentistry | Other Name - Individual/Organization |
Street Address |
1213 COFFEE RD STE E |
City | MODESTO |
State | CA |
Zip Code | 95355-4229 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982211793 | I To I LLC | Optometrist | 3401 Oakdale Rd, Ste 525, Modesto, CA 95355 | 2020-09-25 |
1205443116 | Altwal and Shelat Dds Inc | Dentist | 1317 Oakdale Road, Suite 310, Modesto, CA 95355 | 2020-09-24 |
1184255911 | Reeves, D.d.s. and Lavalley, D.d.s., A Dental Corporation | Clinic/Center | 3401 Oakdale Road, Suite 505, Modesto, CA 95355 | 2020-01-30 |
1487133856 | Natalie Vargas | Behavior Technician | 1317 Oakdale Road Suite 610, Modesto, CA 95355 | 2018-08-07 |
1871079152 | Jill H Fusia | Dietitian, Registered | 1404 Cordero Court, Modesto, CA 95355 | 2018-07-19 |
1043727514 | Emily Lauren Schaefer | Behavioral Analyst | 3425 Coffee Rd Ste C2, Modesto, CA 95355 | 2018-01-05 |
1376083691 | Hari Gnanasekeram, PC | Technician, Cardiology | 1303 Mable Avenu, Modesto, CA 95355 | 2017-03-06 |
1598139891 | Encompass Health Rehabilitation Hospital of Modesto, LLC | Rehabilitation Hospital | 1303 Mable Avenue, Modesto, CA 95355 | 2015-11-24 |
1013387844 | Diana Faith Kigenyi | Social Worker | 1225 Oakdale Road, Modesto, CA 95355 | 2015-10-06 |
1437530672 | Tzu Yi Wei | Acupuncturist | 2209 Coffee Road, Suite A, Modesto, CA 95355 | 2015-06-12 |
Find all providers in zip 95355 |
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 |
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 |
1457466807 | Christopher Dean Anderson | Dentist | 1213 Coffee Rd, Suite G, Modesto, CA 95355-4229 | 2006-08-19 |
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.