MYRNA MENJIVAR GRAY DDS NPI 1194812156

NPI Information

NPI: 1194812156
Provider Name: MYRNA MENJIVAR GRAY, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
701 SONOMA MOUNTAIN PKWY
SUITE E 1
PETALUMA, CA
ZIP 94954
Phone: (707) 782-0789
Get Directions

Myrna Menjivar Gray, DDS is a general practice dentist in Petaluma, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Myrna Menjivar Gray, DDS NPI is 1194812156. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

701 SONOMA MOUNTAIN PKWY
SUITE E 1
PETALUMA, CA
ZIP 94954-518
Phone: (707) 782-0789
Fax: (707) 782-9133

The enumeration date for this NPI number is 10/9/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	30461	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	30461	OTHER	CALIFORNIA	DENTIST LICENCE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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