Organization
COUNTY OF SANTA CLARA
Active
Organization
COUNTY OF SANTA CLARA
Active
Other names
Ronald McDonald Dental Mobile Unit
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO F BANUELOS JR. MD (CHIEF MEDICAL OFFICER)
40888854001
Entity
Organization
Contact information
Practice address
500 TULLY RD, RONALD MCDONALD DENTAL MOBILE UNIT, SAN JOSE, CA 95111-1917
(408) 885-5000
Mailing address
PO BOX 5280, PATIENT BUSINESS SERVICES, SAN JOSE, CA 95150-5280
(408) 885-5000
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC80060F
—
CA
Enumeration date
11/06/2006
Last updated
09/11/2025
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up