1012 GROUP INC NPI 1730535774

NPI Information

  • NPI: 1730535774
  • Provider Name: 1012 GROUP, INC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Doing Business As: BLOOM DENTAL GROUP
  • Address: 800 S B ST
    SUITE #200
    SAN MATEO, CA
    ZIP 94401
  • Phone: (650) 458-3727

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NPI Details

1012 GROUP, INC is a general practice dentist in San Mateo, 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. 1012 GROUP, INC NPI is 1730535774. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Bloom Dental Group.

The provider's business location address is:

800 S B ST
SUITE #200
SAN MATEO, CA
ZIP 94401-271
Phone: (650) 458-3727

The provider's authorized official is Patti Bolander .
The authorized official title is Director Of Operations and has the following contact phone number (650) 458-3727.

The enumeration date for this NPI number is 5/9/2016 and was last updated on 5/9/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice58767CALIFORNIAYes

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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