KEITH TAM DDS PROFESSIONAL CORP (NPI# 1922541481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922541481 |
| Entity Type | Organization |
| Organization Name | KEITH TAM DDS PROFESSIONAL CORP |
| Other Organization Name | SANTA MARIA PEDIATRIC DENTAL GROUP |
| Practice Address |
570 E Betteravia Rd Ste C Santa Maria CA 93454-8805 |
| Practice Telephone | 8059222888 |
| Practice Fax Number | 8059250888 |
| Mailing Telephone | 8059222888 |
| Mailing Fax Number | 8059250888 |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | DR. KEITH TAM (OWNER) |
| Authorized Official Telephone | 9493229778 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 57293 | CA | Dental Providers |
| Other Name | Type Code |
|---|---|
| Santa Maria Pediatric Dental Group | Doing Business As Name - Organization |
| Street Address |
570 E BETTERAVIA RD STE C |
| City | SANTA MARIA |
| State | CA |
| Zip Code | 93454-8805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995825 | Virgilia Elizabeth Kennedy | Counselor | 1505 Shepard Drive, Suite 204, Santa Maria, CA 93454 | 2019-01-05 |
| 1891290151 | Philbert Ramirez Pandac | Behavioral Analyst | 1016 East Maint Street, Santa Maria, CA 93454 | 2018-03-28 |
| 1487166120 | Good Samaritan Shelter | Family Medicine | 412 East Tunnell Street, Santa Maria, CA 93454 | 2017-11-03 |
| 1306357892 | Aklilu Joseph | Pharmacist | 1700 S. Bradley Rd, Santa Maria, CA 93454 | 2017-10-24 |
| 1225557267 | Eric Edward Lofstrand | Counselor | 1214 S Miller St Ste 11, Santa Maria, CA 93454 | 2017-09-11 |
| 1881112449 | Tess Wianecki | Physician Assistant | 116 S Palisade Dr Ste 110, Santa Maria, CA 93454 | 2017-09-05 |
| 1730603705 | Cac Alvin Center | Counselor | 316 E Mcelhany Ave, Santa Maria, CA 93454 | 2017-08-01 |
| 1174045009 | Peter A. Statti Md Inc. | Pediatrics | 1414 S. Miller St. #12, Santa Maria, CA 93454 | 2017-07-12 |
| 1982143970 | Child Abuse Listening Mediation | Community/Behavioral Health | 210 E. Enos Dr., Ste. A, Santa Maria, CA 93454 | 2017-02-23 |
| 1821531344 | Maria Isabel Lara | Counselor | 210 E Enos Dr, Santa Maria, CA 93454 | 2016-12-01 |
| Find all providers in zip 93454 | ||||
| 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 |
|---|---|---|---|---|
| 1780151506 | Brian Turton | Dentist | 1157 E Clark Ave Ste A, Santa Maria, CA 93455-5146 | 2018-10-30 |
| 1053887687 | Derek Appelblatt | Dentist | 1670 S Broadway, Santa Maria, CA 93454-7602 | 2018-10-22 |
| 1063870319 | Ryan Taylor Blatchley | Dentist | 426 Barcellus Ave Ste 105, Santa Maria, CA 93454-6926 | 2016-02-02 |
| 1437553682 | Jesse Kim,dds.inc | Dentist | 1774 S Broadway, Santa Maria, CA 93454-7604 | 2014-10-17 |
| 1386059103 | Anne Pedersen | Dentist | 1414 S Miller St Ste 8, Santa Maria, CA 93454-6961 | 2014-07-01 |
| 1851728984 | Soon Cheol Kwon | Dentist | 1414 South Miller St., Suite S, Santa Maria, CA 93454 | 2013-10-03 |
| 1346571791 | Pedro A Avendano | Dentist | 4012 Cedarhurst Dr Apt 108, Santa Maria, CA 93455-6403 | 2010-01-25 |
| 1265692800 | Naomi Ishibashi | Dentist | 570 E Betteravia Rd Ste C, Santa Maria, CA 93454 | 2008-06-16 |
| 1578767547 | Matthew P Lane | Dentist | 2506 Professional Pkwy, Santa Maria, CA 93455-1602 | 2007-06-13 |
| 1669694758 | John Thomas Whelan | Dentist | 2005 S Miller St, Santa Maria, CA 93454-7849 | 2007-05-02 |
| Find all providers in SANTA MARIA | ||||
| City | SANTA MARIA |
| Zip Code | 93454 |
Please comment or provide details below to improve the information on KEITH TAM DDS PROFESSIONAL CORP.
| 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.