Provider Type Icon

CANYON LAKES DENTAL NPI 1639546252


NPI Information

NPI: 1639546252
Provider Name: CANYON LAKES DENTAL
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
525 BOLLINGER CANYON WAY STE 105
SAN RAMON, CA
ZIP 94582
Phone: (925) 735-3838
Get Directions

CANYON LAKES DENTAL is a general practice dentist in San Ramon, 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. CANYON LAKES DENTAL NPI is 1639546252. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

525 BOLLINGER CANYON WAY STE 105
SAN RAMON, CA
ZIP 94582-935
Phone: (925) 735-3838

The provider's authorized official is David Erik Richard Burke .
The authorized official title is Dentist and has the following contact phone number (231) 735-3715.

The enumeration date for this NPI number is 8/31/2015 and was last updated on 10/7/2016.


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 Practice2901021670MICHIGANYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.