NPIMap

Organization Active NPI

Mauricio Dossantos DDS

  • General Practice Dentistry
  • Yucaipa, CA
National Provider Identifier
1033567441
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61711 Issued in CA
Legal business name
MAURICIO DOSSANTOS DDS
Practice address
12033 4TH St
Suite 7
Yucaipa, CA 92399-2755
Phone
(909) 790-1951
Fax
(909) 790-1561
NPI assigned
May 26, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Authorized official

Name
Dr. Mauricio Dossantos, DDSNPI 1104176817
Title
Owner Dentist
Phone
(909) 709-6766

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 MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 61711 CA Primary

Addresses

Primary practice location

12033 4TH St
Suite 7
Yucaipa, CA 92399-2755

Mailing address

12033 4TH St
Suite 7
Yucaipa, CA 92399-2755
Phone (909) 790-1951

National Provider Directory

National Provider Directory

Locations

12033 4th St
Ste 7
Yucaipa, CA 92399
Phone (909) 790-1951

Practitioners & affiliated clinicians

Practitioners 2

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": "1464220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464220800000",
    "number": "1033567441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12033 4TH ST",
            "address_2": "SUITE 7",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992755",
            "telephone_number": "909-790-1951",
            "fax_number": "909-790-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12033 4TH ST",
            "address_2": "SUITE 7",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992755",
            "telephone_number": "909-790-1951",
            "fax_number": "909-790-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAURICIO DOSSANTOS DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-26",
        "last_updated": "2016-05-26",
        "status": "A",
        "authorized_official_last_name": "DOSSANTOS",
        "authorized_official_first_name": "MAURICIO",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "909-709-6766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucaipa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2016; 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.