NPIMap

Organization Active NPI

Patelprofessional Dental Corp.

  • General Practice Dentistry
  • Rialto, CA
National Provider Identifier
1003259268
Registry record updated Apr 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37000 Issued in CA
Legal business name
PATELPROFESSIONAL DENTAL CORP.
Practice address
579 E Foothill Blvd
Rialto, CA 92376-5223
Phone
(909) 874-5080
Fax
(909) 874-5081
NPI assigned
Apr 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2013

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

Authorized official

Name
Dr. Makbulahmed I Patel, D.D.S.
Title
President
Phone
(909) 874-5080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 37000 CA Primary

Addresses

Primary practice location

579 E Foothill Blvd
Rialto, CA 92376-5223

Mailing address

579 E Foothill Blvd
Rialto, CA 92376-5223
Phone (909) 874-5080

Other names 1

  • Rialto Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Patel Professional Dental Corp4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

579 E Foothill Blvd
Rialto, CA 92376
Phone (909) 874-5080

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365379200000",
    "number": "1003259268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765223",
            "telephone_number": "909-874-5080",
            "fax_number": "909-874-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 E FOOTHILL BLVD",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923765223",
            "telephone_number": "909-874-5080",
            "fax_number": "909-874-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATELPROFESSIONAL DENTAL CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2013-04-08",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "MAKBULAHMED",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-874-5080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rialto Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2013; 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.