SANTA ROSA COMMUNITY DENTAL CENTER
NPI 1023439759
Clinic/Center - Federally Qualified Health Center (FQHC) in Santa Rosa, CA

Q: What is Santa Rosa Community Healt Centers's NPI number?

The NPI number for Santa Rosa Community Healt Centers is 1023439759. It was assigned to this organization in the NPPES registry on December 24, 2013. The provider is doing business as Santa Rosa Community Dental Center.

Q: What is Santa Rosa Community Healt Centers's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Active since December 24, 2013CLIA 05D0911901 · Microscopy

1110 N DUTTON AVE, SANTA ROSA, CA 95401(707) 303-3600(707) 396-5155 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 9, 2022, Apr 4, 2019, Mar 8, 2019 (3 updates tracked since 2019).

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About Santa Rosa Community Dental Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SANTA ROSA COMMUNITY DENTAL CENTER (NPI 1023439759) is a healthcare organization registered as a federally qualified health center (fqhc) in Santa Rosa, California and active in the NPI registry since December 2013. The organization holds a CLIA Microscopy certificate valid through April 10, 2028 and lists Gabriela Bernal-leroi, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1023439759

Entity TypeOrganization

Primary Taxonomy261QF0400X

Legal Business NameSANTA ROSA COMMUNITY HEALT CENTERS

Location Address1110 N DUTTON AVESanta Rosa, CA 95401-4606

Mailing Address3569 Round Barn CirSanta Rosa, CA 95403-5781 · (707) 303-3600 · Fax (707) 396-5155

Phone(707) 303-3600

Fax(707) 396-5155

Organization SubpartNo

Authorized OfficialGabriela Bernal-leroiChief Executive Officer · (707) 303-3600

Enumeration DateDecember 24, 2013

Last NPPES UpdateDecember 9, 20223 updates tracked since enumeration

NPPES CertifiedDecember 9, 2022

✔ NPI 1023439759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities

Taxonomy Code261QF0400X

Also ListedClinic/Center · DentalTaxonomy 261QD0000X

1110 N DUTTON AVE, Santa Rosa, CA 95401

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Other Names 1

Doing Business AsSanta Rosa Community Dental Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 05D0911901

Santa Rosa Community Health Centers · Santa Rosa, CA

Active · expires Apr 10, 2028

CLIA Number05D0911901

Laboratory TypeFederally Qualified Health Center

Certificate Effective DateApril 11, 2026

Certificate Expiration DateApril 10, 2028

Laboratory DirectorMarie Mulligan

Laboratory Phone(707) 303-3600

Laboratory LocationSanta Rosa Community Health Centers301 6th St Ste 214, Santa Rosa, CA 95401

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDMEE MARGUERITE DANAN MD

Neuromusculoskeletal Medicine & OMM