PACIFIC DENTAL GROUP NPI 1669802435

NPI Information

  • NPI: 1669802435
  • Provider Name: PACIFIC DENTAL GROUP
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Address: 1523 5TH AVE
    SAN RAFAEL, CA
    ZIP 94901
  • Phone: (415) 453-6277

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NPI Details

PACIFIC DENTAL GROUP is a general practice dentist in San Rafael, 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. PACIFIC DENTAL GROUP NPI is 1669802435. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1523 5TH AVE
SAN RAFAEL, CA
ZIP 94901-806
Phone: (415) 453-6277
Fax: (415) 453-6412

The provider's authorized official is Clark Fong .
The authorized official title is Owner and has the following contact phone number (415) 453-6277.

The enumeration date for this NPI number is 11/15/2013 and was last updated on 11/15/2013.

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 Practice40351CALIFORNIAYes

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: 11/21/2025

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