# CUPERTINO DENTAL SPECIALTY GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CUPERTINO DENTAL GROUP PARTNERSHIP
- **Other names:** Cupertino Dental Group
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1467105031
- **Legal business name:** CUPERTINO DENTAL GROUP PARTNERSHIP
- **Authorized official:** MELINA LUCCHINI (SUPERVISOR)
- **Authorized official phone:** (408) 257-3031

## Contact information

- **Practice address:** 10373 TORRE AVENUE, SUITE G, CUPERTINO, CA 95014-9501
- **Practice address phone:** (408) 508-7560
- **Practice address fax:** (408) 508-7530
- **Mailing address:** 10383 TORRE AVE STE I, CUPERTINO, CA 95014-3238
- **Mailing address phone:** (408) 257-3031
- **Mailing address fax:** (408) 508-7530

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223P0300X | Periodontics | — | NULL | — |
| 1223P0300X | Periodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 02/02/2022
- **Last updated:** 02/02/2022