NPIMap

Organization Active NPI

Elvia Juarez a Dental Corporation

Doing business as EJ Dental Practice of Dr. Elvia Juarez DDS

  • General Practice Dentistry
  • Cathedral City, CA
National Provider Identifier
1003982638
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41625 Issued in CA
Legal business name
ELVIA JUAREZ A DENTAL CORPORATION
Doing business as
EJ Dental Practice of Dr. Elvia Juarez DDS
Practice address
30877 Date Palm Dr Ste B4
Cathedral City, CA 92234-2957
Phone
(760) 202-7400
Fax
(760) 202-7403
NPI assigned
Nov 27, 2006
Last updated
Aug 17, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Elvia Juarez MataNPI 1689710626
Title
President/ DDS
Phone
(760) 775-5552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41625 CA Primary

Addresses

Primary practice location

30877 Date Palm Dr Ste B4
Cathedral City, CA 92234-2957

Mailing address

30877 Date Palm Dr Ste B4
Cathedral City, CA 92234-2957
Phone (760) 202-7400

Other names 2

  • EJ Dental Practice of Dr. Elvia Juarez DDS Doing business as
  • Elvia Juarez a Dental Corporation Other name

National Provider Directory

National Provider Directory
Tax ID family
Ej Dental6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

30877 Date Palm Dr
Ste B4
Cathedral City, CA 92234
Phone (760) 202-7400

69195 Ramon Rd
Ste C3
Cathedral City, CA 92234
Phone (760) 321-6776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1003982638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30877 DATE PALM DR STE B4",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922342957",
            "telephone_number": "760-202-7400",
            "fax_number": "760-202-7403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30877 DATE PALM DR STE B4",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922342957",
            "telephone_number": "760-202-7400",
            "fax_number": "760-202-7403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVIA JUAREZ A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-27",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "JUAREZ MATA",
        "authorized_official_first_name": "ELVIA",
        "authorized_official_title_or_position": "PRESIDENT/ DDS",
        "authorized_official_telephone_number": "760-775-5552"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EJ Dental Practice of Dr. Elvia Juarez DDS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Elvia Juarez a Dental Corporation",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.