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PETALUMA VALLEY DENTAL NPI 1356438311


NPI Information

NPI: 1356438311
Provider Name: PETALUMA VALLEY DENTAL

Doing Business As: DINU A GRAY/MYRNA MENJIVAR GRAY

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
701 SONOMA MOUNTAIN PKWY
SUITE E 1
PETALUMA, CA
ZIP 94954
Phone: (707) 782-0789
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PETALUMA VALLEY DENTAL 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. PETALUMA VALLEY DENTAL NPI is 1356438311. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Dinu A Gray/myrna Menjivar Gray.

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 provider's authorized official is Myrna Menjivar .
The authorized official title is Partner and has the following contact phone number (415) 299-9566.

The enumeration date for this NPI number is 10/9/2006 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice30433CALIFORNIANo
21223G0001XDentistGeneral Practice30461CALIFORNIAYes

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

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