Provider Demographics
NPI:1851878250
Name:DR. JEFFREY A. SALADIN, DENTAL CORP
Entity Type:Organization
Organization Name:DR. JEFFREY A. SALADIN, DENTAL CORP
Other - Org Name:CHILDREN'S CHOICE PEDIATRIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALADIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-333-0563
Mailing Address - Street 1:1164 NATIONAL DRIVE
Mailing Address - Street 2:SUITE #40
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 RALEY BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928
Practice Address - Country:US
Practice Address - Phone:530-883-8589
Practice Address - Fax:844-534-8464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. JEFFREY A. SALADIN, DENTAL CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-27
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty