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NUT TREE SMILES DENTISTRY AND ORTHODONTICS DENTAL GROUP
NPI 1043589294
Dentist - General Practice in Vacaville, CA

Active since December 16, 2011CLIA 05D2341508 · Waiver
110 NUT TREE PARKWAY, VACAVILLE, CA 95687(707) 451-8390(707) 451-8579 Get Directions Write a Review

NPPES record last updated: November 12, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Nut Tree Smiles Dentistry And Orthodontics Dental Group NPPES

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

NUT TREE SMILES DENTISTRY AND ORTHODONTICS DENTAL GROUP (NPI 1043589294) is a healthcare organization registered as a general practice in Vacaville, California and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through April 1, 2028 and lists Usha Mantena, Owner Doctor, as its authorized official.

NPPES Registry Identity

NPI1043589294
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMANTENA AND GHAZAL DENTAL CORPORATION
Location Address110 NUT TREE PARKWAYVacaville, CA 95687
Mailing Address17000 Red Hill AveIrvine, CA 92614-5626 · (714) 845-8890 · Fax (949) 474-1495
Phone(707) 451-8390
Fax(707) 451-8579
Organization SubpartNo
Authorized OfficialUsha MantenaOwner Doctor · (707) 451-8390
Enumeration DateDecember 16, 2011
Last NPPES UpdateNovember 12, 2013
✔ NPI 1043589294 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
110 NUT TREE PARKWAY, Vacaville, CA 95687
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Other Names 1

Doing Business AsNut Tree Smiles Dentistry And Orthodontics Dental Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 of Waiver 05D2341508

Nut Tree Smiles Dentistry · Vacaville, CA
Active · expires Apr 1, 2028
CLIA Number05D2341508
Laboratory TypePractitioner Other
Certificate Effective DateApril 2, 2026
Certificate Expiration DateApril 1, 2028
Laboratory DirectorSimran Gill
Laboratory Phone(707) 451-8390
Laboratory LocationNut Tree Smiles Dentistry1011 Helen Power Dr, Vacaville, CA 95687
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mantena And Ghazal Dental Corporation's NPI number?

The NPI number for Mantena And Ghazal Dental Corporation is 1043589294. It was assigned to this organization in the NPPES registry on December 16, 2011. The provider is doing business as Nut Tree Smiles Dentistry And Orthodontics Dental Group.

Where is Mantena And Ghazal Dental Corporation located?

Mantena And Ghazal Dental Corporation is located at 110 Nut Tree Parkway, Vacaville, CA 95687. The listed phone number is (707) 451-8390.

What is Mantena And Ghazal Dental Corporation's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Does Mantena And Ghazal Dental Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2341508) is associated with this NPI, valid through April 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mantena And Ghazal Dental Corporation was last updated on November 12, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.