Fruitvale Dental Group

LBN: Richard H. Mogensen Dds Apc
Fruitvale Dental Group is an health care organization with primary practice located at 1624 Franklin St Suite 1206, Oakland CA 94612-2824. The organization recently has only one registered license in Dental Providers / Dentist, which is considered as the primary health care specialty. Richard H. Mogensen Dds Apc can be contacted via phone (510) 452-5555, or through Mogensen, Richard H. via phone (510) 452-5555.

Contact Information

Primary practice address
1624 Franklin St Suite 1206 Oakland CA 94612-2824
Phone: (510) 452-5555
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mogensen, Richard H. Doctor of Dental Surgery (DDS)
Phone: (510) 452-5555

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X CA 21733 California

Profile Details

NPI number 1750595567
LBN Legal business name Richard H. Mogensen Dds Apc
DBA Doing business as Fruitvale Dental Group
Authorized official Mogensen, Richard H. Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date May 10th, 2007
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750595567 NPPES
California MEDICAID G92157-01

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