NPIMap

Organization Active NPI

Clinica Dental Familiar Guadalupana

Doing business as Lourdes Cardoso DDS Inc

  • General Practice Dentistry
  • Fontana, CA
National Provider Identifier
1083847867
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50895 Issued in CA
Legal business name
CLINICA DENTAL FAMILIAR GUADALUPANA
Doing business as
Lourdes Cardoso DDS Inc
Practice address
16701 Valley Blvd Ste D
Fontana, CA 92335-6696
Phone
(909) 356-4490
Fax
(909) 356-5239
NPI assigned
Aug 27, 2009
Last updated
Aug 27, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Authorized official

Name
Elizabeth Duarte
Title
Biller
Phone
(909) 988-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 50895 CA Primary

Addresses

Primary practice location

16701 Valley Blvd Ste D
Fontana, CA 92335-6696

Mailing address

16701 Valley Blvd Ste D
Fontana, CA 92335-6696
Phone (909) 356-4490

Other names 1

  • LOURDES CARDOSO DDS INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clinica Dental Familiar Guadalupana5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

16701 Valley Blvd
Ste D
Fontana, CA 92335
Phone (909) 356-4490

Practitioners & affiliated clinicians

Practitioners 3

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": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1083847867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 VALLEY BLVD STE D",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356696",
            "telephone_number": "909-356-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16701 VALLEY BLVD STE D",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356696",
            "telephone_number": "909-356-4490",
            "fax_number": "909-356-5239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DENTAL FAMILIAR GUADALUPANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "909-988-1800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOURDES CARDOSO DDS INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.