MR. JAMES PETRIK (NPI# 1922453877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922453877 |
| Entity Type | Individual |
| Full Name | MR. JAMES PETRIK |
| Credential | D.D.S. |
| Practice Address |
862 Meinecke Ave Suite 203 San Luis Obispo CA 93405 |
| Practice Telephone | 8055441246 |
| Practice Fax Number | 8055441247 |
| Mailing Telephone | 8055441246 |
| Mailing Fax Number | 8055441247 |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 20657 | CA | Dental Providers |
| Street Address |
862 MEINECKE AVE SUITE 203 |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871537779 | Central Coast Orthopedic Medical Group | Orthopaedic Surgery | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-1721 | 2006-06-15 |
| 1316323926 | Thomas Pacheco | Dentist | 862 Meinecke Ave, Suite 200, San Luis Obispo, CA 93405-1721 | 2015-08-05 |
| 1497135800 | Scott E. Adams, Dpm Inc | Durable Medical Equipment & Medical Supplies | 862 Meinecke Ave, Suite 204, San Luis Obispo, CA 93405-1721 | 2015-06-02 |
| 1871768150 | Nick L. Gunasayan, D.p.m., Inc | Durable Medical Equipment & Medical Supplies | 862 Meinecke Ave, Ste #204, San Luis Obispo, CA 93405-1721 | 2008-04-28 |
| 1619189255 | Lonnie Bob Lassiter | Dentist | 862 Meinecke Ave, #200, San Luis Obispo, CA 93405-1721 | 2007-05-04 |
| 1710051792 | Otto J Schueckler | Orthopaedic Surgery | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-1721 | 2006-11-20 |
| 1962576959 | Kenneth B Fryer | Orthopaedic Surgery | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-1721 | 2006-11-20 |
| 1831262716 | Daniel W Woods | Orthopaedic Surgery | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-1721 | 2006-11-16 |
| 1447338678 | Sean D Devine | Orthopaedic Surgery | 862 Meinecke Ave, Suite 100, San Luis Obispo, CA 93405-1721 | 2006-11-02 |
| 1073693586 | Charles E St. Vincent | Physical Therapist | 862 Meinecke Ave, Ste. 101, San Luis Obispo, CA 93405-1721 | 2006-10-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164076626 | Hilary Abbott Anderson | Physician Assistant | 127 Casa St., San Luis Obispo, CA 93405 | 2019-08-01 |
| 1811465834 | Fatemeh Ladan Ahmadinia | Dentist | 764 N Santa Rosa St, San Luis Obispo, CA 93405 | 2018-11-07 |
| 1538559794 | Arnold Martin Horwitz | Marriage & Family Therapist | 1605 Garnette Drive, San Luis Obispo, CA 93405 | 2015-01-27 |
| 1750794764 | Solmaz Naghsh | Pharmacist | 765 Foothill Blvd, San Luis Obispo, CA 93405 | 2014-06-06 |
| 1609293471 | Robert S. Flores Dmd, Inc | Dentist | 878 Boysen Avenue, San Luis Obispo, CA 93405 | 2014-03-18 |
| 1457776445 | Laura Anne Wilvert | Marriage & Family Therapist | 793 E. Foothill Blvd, Suite A, #278, San Luis Obispo, CA 93405 | 2014-02-27 |
| 1497181200 | Tracey Ruby Madrigal | Counselor | 1106 Oceanaire Dr. #25, San Luis Obispo, CA 93405 | 2013-09-25 |
| 1437597572 | Sarah Michelle Brenis | Counselor | 524 Princeton Place, San Luis Obispo, CA 93405 | 2013-06-11 |
| 1013350974 | Jenna Rose Ramos | Counselor | 1459 Descanso St., San Luis Obispo, CA 93405 | 2013-04-10 |
| 1700140696 | Christopher Dieterich Marchand | Social Worker | 793a E. Foothill Blvd, 190, San Luis Obispo, CA 93405 | 2012-06-26 |
| Find all providers in zip 93405 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922651389 | Nima Mashhoon | Dentist | 3870 Broad St, San Luis Obispo, CA 93401-7172 | 2019-07-24 |
| 1891038527 | Kristina Michelle Cesena | Dentist | 1708 Cordova Dr, San Luis Obispo, CA 93405-4715 | 2013-04-01 |
| 1699911230 | Donald Alan Ellis | Dentist | 2440 Meadow St, San Luis Obispo, CA 93401-5630 | 2009-01-04 |
| 1912153917 | Robert Flores | Dentist | 878 Boysen Ave, San Luis Obispo, CA 93405-1311 | 2008-08-11 |
| 1346423365 | Michael J Murphy | Dentist | California Men's Colony C/o Mike Murphy Dds, Highway 1, San Luis Obispo, CA 93409-0001 | 2007-12-12 |
| 1841473493 | Brent Jennings Hoxie | Dentist | California Men's Colony, Hwy 1, San Luis Obispo, CA 93409-0001 | 2007-12-06 |
| 1942482732 | Ana Maria Pinto | Dentist | Higway 1, San Luis Obispo, CA 93409-0001 | 2007-12-04 |
| 1790966695 | Jeffrey John Bisely | Dentist | California Men's Colony Dental Department, Highway 1, San Luis Obispo, CA 93409-0001 | 2007-11-19 |
| 1114127701 | Carol Lynn Phillips | Dentist | 3046 S Higuera St, Suite C, San Luis Obispo, CA 93401-6622 | 2007-07-20 |
| 1356567614 | Chris W Manning IIi | Dentist | 1194 Pacific St, Suite 203, San Luis Obispo, CA 93401-3305 | 2007-04-17 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93405 |
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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.