1421 Secret Ravine Pkwy, Suite #121, Roseville, CA 95661
Phone
(916) 786-9282
Listed under
Orthodontic practices
NPI
1558458703
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Orthodontics and Dentofacial Orthopedics (1223X0400X)
License number on NPI record
35615 (CA)
Authorized official
Mark Holt, DDS, MS, President
NPI first issued
Oct 9, 2006
NPI record last updated
Aug 22, 2020
NPI 1558458703 is active in the federal NPPES registry (CMS) with Orthodontics and Dentofacial Orthopedics, an ADA-recognized dental specialty, as its primary taxonomy; license 35615 (CA) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.
What these registry facts mean
The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Orthodontists are dentists who completed an accredited orthodontic residency after dental school. General dentists can also offer braces or aligners, but they are not listed here.
Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Orthodontics lists board-certified orthodontists.