Organization Active NPI

Mira Loma Dental

  • Dentist
  • Jurupa Valley, CA
National Provider Identifier
1003440207
Registry record updated Feb 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MIRA LOMA DENTAL
Practice address
11058 Limonite Ave
Jurupa Valley, CA 91752-2120
Phone
(951) 737-6005
Fax
(951) 737-9370
NPI assigned
Feb 26, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2020

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

Authorized official

Name
Dinesh Makadia, DDS
Title
Dentist/Owner
Phone
(909) 737-6005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

11058 Limonite Ave
Jurupa Valley, CA 91752-2120

Mailing address

11058 Limonite Ave
Jurupa Valley, CA 91752-2120
Phone (951) 737-6005

National Provider Directory

National Provider Directory

Locations

11058 Limonite Ave
Jurupa Valley, CA 91752
Phone (951) 737-6005

Practitioners & affiliated clinicians

Practitioners 1

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": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1003440207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11058 LIMONITE AVE",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917522120",
            "telephone_number": "951-737-6005",
            "fax_number": "951-737-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11058 LIMONITE AVE",
            "city": "JURUPA VALLEY",
            "state": "CA",
            "postal_code": "917522120",
            "telephone_number": "951-737-6005",
            "fax_number": "951-737-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRA LOMA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "MAKADIA",
        "authorized_official_first_name": "DINESH",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "909-737-6005",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jurupa Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; 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.