PENINSULA PEDIATRIC DENTAL PRACTICE
NPI 1639590003
Dentist - Pediatric Dentistry in San Mateo, CA

NPI Status: Active since January 02, 2014

Contact Information

50 S SAN MATEO DR STE 160
SAN MATEO, CA
ZIP 94401
Phone: (650) 375-8300
Fax: (650) 375-8130

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  • Organization
  • Dentist
  • Pediatric Dentistry

About PENINSULA PEDIATRIC DENTAL PRACTICE

This page provides the complete NPI Profile along with additional information for Peninsula Pediatric Dental Practice, a provider established in San Mateo, California operating as a Dentist, focusing in pediatric dentistry . The healthcare provider is registered in the NPI registry with number 1639590003 assigned on January 2014. The practitioner's primary taxonomy code is 1223P0221X with license number 61391 (CA). The provider is registered as an organization and their NPI record was last updated 12 years ago. Peninsula Pediatric Dental Practice operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Jan Murray (Office Manager)

NPI
1639590003
Provider Name
PENINSULA PEDIATRIC DENTAL PRACTICE
Entity Type
Organization
Location Address
50 S SAN MATEO DR STE 160 SAN MATEO, CA 94401
Location Phone
(650) 375-8300
Location Fax
(650) 375-8130
Mailing Address
50 S SAN MATEO DR STE 160 SAN MATEO, CA 94401
Mailing Phone
(650) 375-8300
Mailing Fax
(650) 375-8130
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-02-2014
Last Update Date
01-02-2014
Code Navigator

A dentist like Peninsula Pediatric Dental Practice is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist Pediatric Dentistry

Taxonomy Code
1223P0221X
Type
Dental Providers
License No.
61391
License State
CA
Taxonomy Description
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11223P0221XDental Providers

Dentist
Pediatric Dentistry

22673 (CA)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JAN MURRAY

Authorized Official Title
OFFICE MANAGER
Authorized Official Phone
(650) 375-8300

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
1386792919OTHER (01)CAALL INSURANCE CARRIER
1386792919OTHER (01)CADENTICAL

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1639590003
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2669109000
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 6 + 6 + 9 + 1 + 0 + 9 + 0 + 0 + 0 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1639590003 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1023412921DR. BRADLEY SMITH D.M.D.
Individual
Dentist (Orthodontics and Dentofacial Orthopedics)50 S SAN MATEO DR STE 160
SAN MATEO, CA 94401
(305) 778-0827
1790096154DR. TYLER DAVIS DMD
Individual
Dentist (Pediatric Dentistry)50 S SAN MATEO DR STE 160
SAN MATEO, CA 94401
(650) 375-8300

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1639590003, enumerated in the NPI registry as an "organization" on January 02, 2014

The provider is located at 50 S San Mateo Dr Ste 160 San Mateo, Ca 94401 and the phone number is (650) 375-8300

This medical organization specializes in Dentist with taxonomy code 1223P0221X with a focus in Pediatric Dentistry

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on January 02, 2014. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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