NPIMap

Organization Active NPI

Yaowarattana DDS, Inc.

  • General Practice Dentistry
  • Grand Terrace, CA
National Provider Identifier
1033362215
Registry record updated Dec 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
52133 Issued in CA
Legal business name
YAOWARATTANA DDS, INC.
Practice address
22737 Barton Rd
Suite 12
Grand Terrace, CA 92313-5262
Phone
(909) 825-3000
NPI assigned
Oct 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2009

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

Authorized official

Name
Dr. Lalisa Yaowarattana, D.D.SNPI 1891860912
Title
Owner
Phone
(909) 825-3000

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 DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 52133 CA Primary

Addresses

Primary practice location

22737 Barton Rd
Suite 12
Grand Terrace, CA 92313-5262

Mailing address

22737 Barton Rd
Suite 12
Grand Terrace, CA 92313-5262
Phone (909) 825-3000

National Provider Directory

National Provider Directory

Locations

22737 Barton Rd
Ste 12
Grand Terrace, CA 92313
Phone (909) 825-3000

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": "1225411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261526400000",
    "number": "1033362215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22737 BARTON RD",
            "address_2": "SUITE 12",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135262",
            "telephone_number": "909-825-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22737 BARTON RD",
            "address_2": "SUITE 12",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135262",
            "telephone_number": "909-825-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YAOWARATTANA DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-31",
        "last_updated": "2009-12-23",
        "status": "A",
        "authorized_official_last_name": "YAOWARATTANA",
        "authorized_official_first_name": "LALISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-825-3000",
        "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": "52133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2009; 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.