Pacific Dental Group
NPI 1669802435ActiveOrganization· Dentist, General Practice· San Rafael, CA
Dentist, General Practice in San Rafael, California, registered in NPPES in November 2013. The authorized official on file is Clark Fong, DDS, Owner.
Overview
| NPI | 1669802435 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Nov 15, 2013 |
| Last updated in NPPES | Nov 15, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, General Practice Primary | 1223G0001X | 40351 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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