Organization
PENINSULA PEDIATRIC DENTAL PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAN MURRAY (OFFICE MANAGER)
(650) 375-8300
Entity
Organization
Contact information
Practice address
50 S SAN MATEO DR STE 160, SAN MATEO, CA 94401-3859
(650) 375-8300
(650) 375-8130
Mailing address
50 S SAN MATEO DR STE 160, SAN MATEO, CA 94401-3859
(650) 375-8300
(650) 375-8130
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
22673
CA
1223P0221X
Pediatric Dentistry
Primary
61391
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386792919
DENTICAL
CA
Enumeration date
01/02/2014
Last updated
01/02/2014
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