Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Summit Dental Practice

Organization Dentist · NPI 1578956363

Summit Dental Practice is a Dentist in Folsom, California. Licensed in California. Registered with an NPI since 2015.

Licensed in
CA
In the registry since
2015

Practice location Address checks out

25004 Blue Ravine Rd
Folsom, CA 95630-5283
Phone: (916) 355-8400
Fax: (916) 355-8460
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence 39990 (CA)

Record details

NPI number1578956363
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mahnaz Moussavi — Dds · (916) 355-8400
NPI enumeratedMarch 18, 2015
Last updated in NPPESMarch 18, 2015
Mailing address25004 Blue Ravine Rd, Folsom, CA 95630-5283

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