MEDICARE: PLEASANT VALLEY DENTAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	D43010	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1854195417	OTHER	CA	NPI FROM PRIMARY OFFICE AT DIAMOND SPRINGS DENTAL CENTER

General Provider Information

NPI Number	:	1790921989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLEASANT VALLEY DENTAL

Provider Business Mailing Address
First Line	:	PO BOX 568
Second Line	:
City	:	EL DORADO
State	:	CA
Zip	:	95623-0568
Country	:	US
Telephone Number	:	530-622-2862
Fax Number	:	530-622-2072

Provider Business Practice Location Address
First Line	:	6400 PLEASANT VALLEY RD
Second Line	:
City	:	EL DORADO
State	:	CA
Zip	:	95623-4230
Country	:	US
Telephone Number	:	530-622-2862
Fax Number	:	530-622-2072

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MITCHELL A GOODIS
Credential	:	DDS
Telephone Number	:	530-344-0290

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	09/28/2010

Similar Medicare Providers

1821804170 — T. RUTNER DDS DENTAL CORPORATION
Practice Location Address:

6400 PLEASANT VALLEY RD
EL DORADO, CA
95623-4230

Practice Phone: 530-344-0290
Practice Fax: 530-344-0291

1013080944 — DR. JAMES E TURNER M.D.
Practice Location Address:

4230 MARBLE RIDGE RD
EL DORADO HILLS, CA
95762-6606

Practice Phone: 530-671-3526
Practice Fax: 530-671-3552

1952489692 — CHARLES D. MOORE MD
Practice Location Address:

6296 CANARY LN
EL DORADO, CA
95623-4968

Practice Phone: 916-296-3529
Practice Fax:

1730245762 — MR. JOHN H. PROCK MFT
Practice Location Address:

6980 CRYSTAL BLVD
EL DORADO, CA
95623-4866

Practice Phone: 530-620-5577
Practice Fax:

1811196603 — MARTIN YABLONOVSKY D.C.
Practice Location Address:

6211B PLEASANT VALLEY RD
EL DORADO, CA
95623-4232

Practice Phone: 530-622-7600
Practice Fax:

1558796854 — COURTNEY JEAN UPPENDAHL LMFT
Practice Location Address:

PO BOX 1312
EL DORADO, CA
95623-1312

Practice Phone: 530-497-0909
Practice Fax:

Directions to “PLEASANT VALLEY DENTAL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.