Miro Itskovich, DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

MIRO ITSKOVICH, DDS INC.

Practice address

847 Philadelphia St.
Pomona, CA 91766-5714

Phone

(909) 927-4177

NPI assigned

Jul 29, 2008

Last updated

Jul 29, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Miro Itskovich

Title

President

Phone

(909) 927-4177

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1003072141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 PHILADELPHIA ST.",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 PHILADELPHIA ST.",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917665714",
            "telephone_number": "909-927-4177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRO ITSKOVICH, DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-29",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "ITSKOVICH",
        "authorized_official_first_name": "MIRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-927-4177"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Parisa Mirjalili
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• Francis Gabriel Mision, PHARMD
• Alyssa Missakian
• Mission City Community Network, Inc.
• Mission City Community Network, Inc.

• General Practice Dentistry in Pomona, CA
• Providers in Pomona, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.