Summit Dental Practice

Dentist · Folsom, CA

Organization Active NPI

NPI number 1578956363

Practice location

25004 Blue Ravine Rd
Folsom, CA 95630-5283
Phone
(916) 355-8400
Fax
(916) 355-8460

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NPI record

NPI
1578956363
Entity type
Organization (Type 2)
Enumeration date
March 18, 2015
Last updated
March 18, 2015
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 39990 CA

Authorized official

Name
Mahnaz Moussavi
Title
DDS
Phone
(916) 355-8400

About Summit Dental Practice

Summit Dental Practice is a healthcare organization registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 25004 Blue Ravine Rd, Folsom, CA 95630-5283. The NPI number 1578956363 was assigned on March 18, 2015 and the record was last updated on March 18, 2015.

Summit Dental Practice lists a license in the registry: #39990 (CA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Mahnaz Moussavi, DDS.

Frequently asked questions

What is the NPI number of Summit Dental Practice?

The NPI number is 1578956363.

What is the phone number of Summit Dental Practice?

The phone number listed for the practice location is (916) 355-8400.

Where is Summit Dental Practice located?

25004 Blue Ravine Rd, Folsom, CA 95630-5283.

What is the taxonomy code for Summit Dental Practice?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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