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PETALUMA DENTAL GROUP
NPI 1275776684
Dentist - General Practice in Petaluma, CA

Active since April 15, 2009
1430 E WASHINGTON ST, PETALUMA, CA 94954(707) 762-0067(707) 762-4782 Get Directions Write a Review

NPPES record last updated: April 15, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Petaluma Dental Group NPPES

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

PETALUMA DENTAL GROUP (NPI 1275776684) is a healthcare organization registered as a general practice in Petaluma, California and active in the NPI registry since April 2009. The organization lists Debra A Quackenbush, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1275776684
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMANGRUM DENTAL CORPORATION
Location Address1430 E WASHINGTON STPetaluma, CA 94954-3631
Mailing Address1430 E Washington StPetaluma, CA 94954-3631 · (707) 762-0067 · Fax (707) 762-4782
Phone(707) 762-0067
Fax(707) 762-4782
Organization SubpartNo
Authorized OfficialDebra A QuackenbushOffice Manager · (707) 762-0067
Enumeration DateApril 15, 2009
✔ NPI 1275776684 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 44612
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.
1430 E WASHINGTON ST, Petaluma, CA 94954
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Other Names 1

Doing Business AsPetaluma 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

Other Providers at the Same Location NPPES 2

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

DR. THOMAS VINCENT DEMBSKI DDS
Dentist
1430 E WASHINGTON ST
PETALUMA, CA 94954
Sonoma County (707) 762-0067
RICHARD KORMAN DDS
Dentist (General Practice)
1430 E WASHINGTON ST
PETALUMA, CA 94954
Sonoma County (707) 762-0067

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 Mangrum Dental Corporation's NPI number?

The NPI number for Mangrum Dental Corporation is 1275776684. It was assigned to this organization in the NPPES registry on April 15, 2009. The provider is doing business as Petaluma Dental Group.

Where is Mangrum Dental Corporation located?

Mangrum Dental Corporation is located at 1430 E Washington St, Petaluma, CA 94954. The listed phone number is (707) 762-0067.

What is Mangrum Dental Corporation's specialty?

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

When was this NPI record last updated?

The NPPES record for Mangrum Dental Corporation was last updated on April 15, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.