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PENINSULA PEDIATRIC DENTAL PRACTICE
NPI 1639590003
Dentist - Pediatric Dentistry in San Mateo, CA

Active since January 02, 2014
50 S SAN MATEO DR STE 160, SAN MATEO, CA 94401(650) 375-8300(650) 375-8130 Get Directions Write a Review

NPPES record last updated: January 2, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Peninsula Pediatric Dental Practice NPPES

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

PENINSULA PEDIATRIC DENTAL PRACTICE (NPI 1639590003) is a healthcare organization registered as a pediatric dentistry in San Mateo, California and active in the NPI registry since January 2014. The organization lists Jan Murray, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1639590003
Entity TypeOrganization
Primary Taxonomy1223P0221X
Legal Business NamePENINSULA PEDIATRIC DENTAL PRACTICE
Location Address50 S SAN MATEO DR STE 160San Mateo, CA 94401-3859
Mailing Address50 S San Mateo Dr Ste 160San Mateo, CA 94401-3859 · (650) 375-8300 · Fax (650) 375-8130
Phone(650) 375-8300
Fax(650) 375-8130
Organization SubpartNo
Authorized OfficialJan MurrayOffice Manager · (650) 375-8300
Enumeration DateJanuary 2, 2014
✔ NPI 1639590003 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Pediatric DentistryDental Providers
Taxonomy Code1223P0221X
Licenses✔ Licensed in CA · 61391✔ Licensed in CA · 22673
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
50 S SAN MATEO DR STE 160, San Mateo, CA 94401
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Other Identifiers 2

Other1386792919CA · All Insurance Carrier
Other1386792919CA · Dentical

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. BRADLEY SMITH D.M.D.
Dentist (Orthodontics and Dentofacial Orthopedics)
50 S SAN MATEO DR STE 160
SAN MATEO, CA 94401
San Mateo County (305) 778-0827
DR. TYLER DAVIS DMD
Dentist (Pediatric Dentistry)
50 S SAN MATEO DR STE 160
SAN MATEO, CA 94401
San Mateo County (650) 375-8300

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 Peninsula Pediatric Dental Practice's NPI number?

The NPI number for Peninsula Pediatric Dental Practice is 1639590003. It was assigned to this organization in the NPPES registry on January 2, 2014.

Where is Peninsula Pediatric Dental Practice located?

Peninsula Pediatric Dental Practice is located at 50 S San Mateo Dr Ste 160, San Mateo, CA 94401. The listed phone number is (650) 375-8300.

What is Peninsula Pediatric Dental Practice's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Pediatric Dentistry, with taxonomy code 1223P0221X.

When was this NPI record last updated?

The NPPES record for Peninsula Pediatric Dental Practice was last updated on January 2, 2014. 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.