SYCAMORE FAMILY DENTISTRY NPI 1487969028

NPI Information

  • NPI: 1487969028
  • Provider Name: SYCAMORE FAMILY DENTISTRY
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • CLIA Number: 05D0947246
  • Address: 1581 SYCAMORE AVE
    SUITE 3
    HERCULES, CA
    ZIP 94547
  • Phone: (510) 799-2900

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NPI Details

SYCAMORE FAMILY DENTISTRY is a general practice dentist in Hercules, 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. SYCAMORE FAMILY DENTISTRY NPI is 1487969028. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1581 SYCAMORE AVE
SUITE 3
HERCULES, CA
ZIP 94547-700
Phone: (510) 799-2900
Fax: (510) 799-2902

The provider's authorized official is Elmer Santos De Leon .
The authorized official title is President/ceo and has the following contact phone number (510) 799-2900.

The CLIA number assigned to this NPI record is 05D0947246 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/6/2010 and was last updated on 8/6/2010.

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
11223G0001XDentistGeneral Practice55619CALIFORNIAYes

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: 3/30/2025

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