Active NPI
Guillermo Alberto Canjura Jr., D.D.S
- Dentist
- Chino, CA
National Provider Identifier
1073752390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 41592
- Practice address
- 5365 Walnut Ave.
Suite E
Chino, CA 91710 - Phone
- (909) 902-1300
- Fax
- (909) 902-1303
- NPI assigned
- Feb 10, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 41592 | CA | Primary |
Addresses
Primary practice location
5365 Walnut Ave.
Suite E
Chino, CA 91710
Mailing address
5365 Walnut Ave.
Suite E
Chino, CA 91710
Phone (909) 902-1300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41592 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234224000000",
"number": "1073752390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5365 WALNUT AVE.",
"address_2": "SUITE E",
"city": "CHINO",
"state": "CA",
"postal_code": "91710",
"telephone_number": "909-902-1300",
"fax_number": "909-902-1303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5365 WALNUT AVE.",
"address_2": "SUITE E",
"city": "CHINO",
"state": "CA",
"postal_code": "91710",
"telephone_number": "909-902-1300",
"fax_number": "909-902-1303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANJURA",
"first_name": "GUILLERMO",
"middle_name": "ALBERTO",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-02-10",
"last_updated": "2009-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "41592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 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.