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THE DENTISTS CLINIC NPI 1093909558


NPI Information

NPI: 1093909558
Provider Name: THE DENTISTS CLINIC

Doing Business As: ISA DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
761 S MARINE CORPS DRIVE
SUITE A-2 CENTAM BUILDING
TAMUNING, GU
ZIP 96913
Phone: (671) 646-7982
Get Directions

THE DENTISTS CLINIC is a general practice dentist in Tamuning, GU. 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. THE DENTISTS CLINIC NPI is 1093909558. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Isa Dental.

The provider's business location address is:

761 S MARINE CORPS DRIVE
SUITE A-2 CENTAM BUILDING
TAMUNING, GU
ZIP 96913
Phone: (671) 646-7982
Fax: (671) 646-7989

The provider's authorized official is Jeffrey Charles Johnson .
The authorized official title is General Partner and has the following contact phone number (671) 646-7982.

The enumeration date for this NPI number is 8/28/2007 and was last updated on 8/28/2007.


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
11223P0221XDentistPediatric DentistryD 901GUAMNo
21223G0001XDentistGeneral PracticeD 829GUAMYes

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
1185MEDICAIDGUAM
2555029OTHERHAWAIIHAWAII DENTAL SERVICES

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: 5/5/2024

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