DR. DARYL JAMES DUDUM (NPI# 1881841252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881841252 |
| Entity Type | Individual |
| Full Name | DR. DARYL JAMES DUDUM |
| Credential | D.D.S. |
| Practice Address |
1748 Novato Blvd Ste 200 Novato CA 94947-7855 |
| Mailing Address |
3495 Freeman Rd Walnut Creek CA 94595-1311 |
| Practice Telephone | 4158987093 |
| Practice Fax Number | 4158980563 |
| Mailing Telephone | 3102666515 |
| Mailing Fax Number | 4158980563 |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2014-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 10267 | MA | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
57731 | CA | Dental Providers |
| N | 1223E0200X |
Dentist Specialization: Endodontics |
25288 | TX | Dental Providers |
| Street Address |
1748 NOVATO BLVD STE 200 |
| City | NOVATO |
| State | CA |
| Zip Code | 94947-7855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407135882 | Rainey Sealey Temkin | Psychologist | 1682 Novato Blvd Ste 105, Novato, CA 94947 | 2011-08-16 |
| 1801192786 | Barbara Jean Gosselin | Marriage & Family Therapist | 1748 Novato Blvd Suite 210, Novato, CA 94947 | 2011-02-10 |
| 1659681377 | Karen Ann Murphy | Occupational Therapist | 27 Stasia Dr., Novato, CA 94947 | 2010-10-15 |
| 1154659415 | Christopher Michael Hackett | Chiropractor | 1559 South Novato Blvd., Suite E, Novato, CA 94947 | 2009-11-25 |
| 1003068305 | Suttinee Saguandeekul | Pharmacist | 910 Diablo Ave, Novato, CA 94947 | 2008-10-17 |
| 1891983581 | Shital Gandhi | Radiology | 500 Redwood Blvd Ste 300, Novato, CA 94947 | 2007-10-09 |
| 1356544126 | Victoria Elizabeth Herzog | Marriage & Family Therapist | 1682 Novato Blvd, Suite 250a, Novato, CA 94947 | 2007-06-07 |
| 1912047655 | Michael Craig Corder | Chiropractor | 1553 S Novato Blvd, A2 Corder Chiropractic Office, Novato, CA 94947 | 2007-02-08 |
| 1427106905 | Jacob Kyle Leone | Naturopath | 1748 Novato Blvd, Suite 100, Novato, CA 94947 | 2007-01-08 |
| 1881756401 | Mental Health Management I, Inc. | Psychiatric Residential Treatment Facility | 655 Canyon Road, Novato, CA 94947 | 2006-12-14 |
| Find all providers in zip 94947 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235283797 | Anne-li Knuut | Dentist | 190 San Marin Dr, Suite C, Novato, CA 94945-1218 | 2007-01-22 |
| 1407911886 | Nader Mehra Vafaie | Dentist | 1615 Hill Rd, Suite #19, Novato, CA 94947-4340 | 2006-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578655 | Pinole Endodontics | Dentist | 2150 Appian Way Ste 207, Pinole, CA 94564-2520 | 2020-11-05 |
| 1518566702 | Sp Endodontics Partnershiop | Dentist | 1300 W Lodi Ave Ste N, Lodi, CA 95242-3038 | 2020-10-20 |
| 1215535661 | Ascella Justine Ronson | Dentist | 35395 Linda Rosea Rd, Temecula, CA 92592-9532 | 2020-10-16 |
| 1457964215 | Lars Bjorn Jonsson, D.d.s., M.s., Inc. | Dentist | 25261 Paseo De Valencia Ste 3, Laguna Hills, CA 92637-4966 | 2020-08-31 |
| 1952929333 | Noureldin Shoreibah Dds Inc | Dentist | 7677 Center Ave Ste 210, Huntington Beach, CA 92647-9103 | 2020-07-11 |
| 1558984799 | Integrative Endodontics, Inc | Dentist | 10850 Wilshine Blvd Ste 301, Los Angeles, CA 90027 | 2020-05-22 |
| 1568091833 | M. Potti Dds Msd Inc | Dentist | 6400 Village Pkwy Ste 100, Dublin, CA 94568-3007 | 2020-04-07 |
| 1194356840 | Liang Dental Group Inc | Dentist | 5562 Philadelphia St Ste 211, Chino, CA 91710-2499 | 2020-01-31 |
| 1699313015 | Paul Erben Dmd Msd PC | Dentist | 937 E Main St Ste 204, Santa Maria, CA 93454-5309 | 2019-12-16 |
| 1396382495 | Narbeh Bandary Dental Corp | Dentist | 4910 Van Nuys Blvd Ste 100, Sherman Oaks, CA 91403-1718 | 2019-12-08 |
| Find all providers with the same taxonomy | ||||
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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.