Mauricio Dossantos, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61711 Issued in CA

Practice address

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

Phone

(909) 790-1951

Fax

(909) 790-1561

NPI assigned

Sep 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mauricio Dossantos DDS

  • General Practice Dentistry
  • Yucaipa, CA
  • NPI 1033567441
  NPD (past) Authorized official
• Sang C Paik DDS

  • Dentist
  • Fortana, CA
  • NPI 1740406784
  NPD (past)

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

{
    "created_epoch": "1347321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1104176817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12033 4TH ST STE 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 STE 7",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992755",
            "telephone_number": "909-790-1951",
            "fax_number": "909-790-1561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1745 N Riverside Ave",
            "address_purpose": "LOCATION",
            "city": "Rialto",
            "state": "CA",
            "postal_code": "923768062",
            "country_code": "US",
            "telephone_number": "909-874-0132",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOSSANTOS",
        "first_name": "MAURICIO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-11",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huy Van DO
• Domel Inc.
• Brandon L Dominguez, RN
• Kofi N Donkor, PHARMD, BCOP, MHA
• Sahil Anup Dosaj, O.D.
• Richard D Doty, M.D.
• Jennifer Ruth Downey, MFT
• Ana Mayra Duardo
• Sara Duenas
• Kristin Durley

• General Practice Dentistry in Yucaipa, CA
• Providers in Yucaipa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; 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.