MARIA TERESA R DE GUZMAN DDS CORP (NPI# 1932650249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932650249 |
| Entity Type | Organization |
| Organization Name | MARIA TERESA R DE GUZMAN DDS CORP |
| Other Organization Name | MYTOOTHSPA DENTISTRY |
| Practice Address |
5060 Sunrise Blvd Suite A1 Fair Oaks CA 95628-4944 |
| Mailing Address |
5060 Sunrise Blvd Ste A4 Fair Oaks CA 95628-4944 |
| Practice Telephone | 9168630456 |
| Practice Fax Number | 9169100751 |
| Mailing Telephone | 9169100708 |
| Mailing Fax Number | 9169100751 |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2016-10-21 |
| Authorized Official Name | MR. ANTHONY E DEGUZMAN (ADMINISTRATOR) |
| Authorized Official Telephone | 9169195721 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QS0112X |
Clinic/Center Specialization: Oral and Maxillofacial Surgery |
41390 | CA | Ambulatory Health Care Facilities |
| Y | 305R00000X | Preferred Provider Organization | 41390 | CA | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| MYTOOTHSPA DENTISTRY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487031027 | Maria Teresa R De Guzman Dds Corp | Preferred Provider Organization | 2436 Professional Dr, Suite 200, Roseville, CA 95661-7779 | 2015-05-04 |
| 1255728408 | Maria Teresa R De Guzman Dds Corp | Dentist | 6600 Madison Ave, Suite 3, Carmichael, CA 95608-0645 | 2015-04-24 |
| Street Address |
5060 SUNRISE BLVD SUITE A1 |
| City | FAIR OAKS |
| State | CA |
| Zip Code | 95628-4944 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346368032 | Maria Teresa Ramos De Guzman | Dentist | 5060 Sunrise Blvd, Suite A5, Fair Oaks, CA 95628-4944 | 2007-03-27 |
| 1528592672 | Dentists Dynamic Services Inc | Dentist | 5060 Sunrise Blvd, Suite A5, Fair Oaks, CA 95628-4944 | 2017-04-15 |
| 1164819710 | Maria Teresa R De Guzman Dds Corp Inc | Dentist | 5060 Sunrise Blvd, Suite A1, Fair Oaks, CA 95628-4944 | 2015-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103590 | Nora's Home Care, Inc | Assisted Living Facility | 5813 Kenneth Ave, Fair Oaks, CA 95628 | 2018-08-08 |
| 1124545512 | Shelby Matthews | Behavior Technician | 7712 Magnolia Ave, Fair Oaks, CA 95628 | 2017-08-25 |
| 1386166908 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. B, Fair Oaks, CA 95628 | 2017-07-14 |
| 1063934867 | Harcourt Bridges, LLC | Counselor | 4112 Crestline Ave Ste. A, Fair Oaks, CA 95628 | 2017-07-13 |
| 1467986075 | Shelby Bryeans | Behavior Technician | 7949 California Ave Ste 15, Fair Oaks, CA 95628 | 2017-04-20 |
| 1942698790 | Life Span Home, Inc | Home Health | 4041 Bridge Street, Fair Oaks, CA 95628 | 2015-01-02 |
| 1861808008 | Edward John Olson | Social Worker | 5213 Vista Del Oro Way, Fair Oaks, CA 95628 | 2014-07-09 |
| 1073924643 | Frank Gontarski | Dentist | 4363 Hazel Avenue, Suite 6, Fair Oaks, CA 95628 | 2014-05-16 |
| 1801232921 | Lisa Hitomi | Community Health Worker | 9915 Fair Oaks Blvd, Fair Oaks, CA 95628 | 2013-05-15 |
| 1972842375 | Nicole Diana Cable | Marriage & Family Therapist | 10217 Fair Oaks Blvd, Suite A, Fair Oaks, CA 95628 | 2013-02-05 |
| Find all providers in zip 95628 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1356806525 | Premierone Plus Aco | Preferred Provider Organization | 1210 N Jefferson St Ste D, Anaheim, CA 92807-1630 | 2019-02-01 |
| 1548730450 | Mastour & Fard Dental Corp | Preferred Provider Organization | 587 N. Ventu Park Road., Suite C, Newberry Park, CA 91320 | 2018-12-04 |
| 1689151698 | David W Schwartz Md A Medical Corporation | Preferred Provider Organization | 29645 Rancho California Rd Ste 105, Temecula, CA 92591 | 2018-07-23 |
| 1184100471 | Care Allies Ipa, Inc | Preferred Provider Organization | 1211 W La Palma Ave Ste 309, Anaheim, CA 92801-2811 | 2018-07-19 |
| 1245723071 | Pacific Associates Medical Group, Inc. | Preferred Provider Organization | 9900 Lakewood Blvd Ste 103, Downey, CA 90240-4039 | 2018-06-06 |
| 1821585266 | Anthony Nguyen Dds Inc | Preferred Provider Organization | 1125 E 17th St Ste N156, Santa Ana, CA 92701-2215 | 2018-04-20 |
| 1275038051 | Ryan Lange D.m.d. Inc. | Preferred Provider Organization | 17897 Macarthur Blvd Ste 100, Irvine, CA 92614-0532 | 2018-03-26 |
| 1649798190 | Freedom Physicians Corporation | Preferred Provider Organization | 2295 Huntington Dr., Ste. D, San Marino, CA 91108 | 2017-09-05 |
| 1952835282 | Dr. Jose Flores D.d.s Inc. | Preferred Provider Organization | 11510 Downey Ave, Downey, CA 90241 | 2017-04-13 |
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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.