OrganizationActive
Mangrum Dental Corporation
NPI 1275776684 · General Practice Dentistry · Petaluma, CA
Mangrum Dental Corporation is a General Practice Dentistry organization in Petaluma, CA (NPI 1275776684).
Provider details
- NPI number
- 1275776684
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Debra Quackenbush, Office Manager(707) 762-0067
- License
- 44612 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(85/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1430 E Washington St
Petaluma, CA 94954-3631
Phone: (707) 762-0067
Fax: (707) 762-4782
Street-level locationGet directions
Mailing address
1430 E Washington St
Petaluma, CA 94954-3631
Other names (DBA / former)
- Doing business as
- Petaluma Dental Group
Registry dates
- Enumerated
- 2009-04-15
- Last updated
- 2009-04-15
Frequently asked questions
- What is Mangrum Dental Corporation's NPI number?
- Mangrum Dental Corporation's National Provider Identifier (NPI) is 1275776684, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Mangrum Dental Corporation?
- Mangrum Dental Corporation is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Mangrum Dental Corporation located?
- Mangrum Dental Corporation's practice location on file with NPPES is 1430 E Washington St, Petaluma, CA 94954-3631.
- What is Mangrum Dental Corporation's phone number?
- The practice phone number listed in the NPPES registry for Mangrum Dental Corporation is (707) 762-0067.
- Who is the authorized official for Mangrum Dental Corporation?
- The authorized official listed on Mangrum Dental Corporation's NPPES record is Debra Quackenbush, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Mangrum Dental Corporation's NPI active?
- Yes — Mangrum Dental Corporation's NPI (1275776684) is active in the NPPES registry as of the last update on 2009-04-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.