NPIMap

Organization Active NPI

McCormack Dental Imaging

  • Dental Laboratory
  • Encinitas, CA
National Provider Identifier
1104286996
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental LaboratoryTaxonomy code 292200000X
License
RHP00053519 Issued in CA
Legal business name
MCCORMACK DENTAL IMAGING
Practice address
317 N El Camino Real
Ste. 301
Encinitas, CA 92024-2811
Phone
(760) 942-2133
NPI assigned
Mar 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Mr. Jerome N. Peck, DLXT
Title
Ceo
Phone
(415) 421-1389

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Laboratory 292200000X RHP00053519 CA Primary

Addresses

Primary practice location

317 N El Camino Real
Ste. 301
Encinitas, CA 92024-2811

Mailing address

450 Sutter St
Ste. 1542
San Francisco, CA 94108-4206
Phone (415) 421-1389

National Provider Directory

National Provider Directory
Tax ID family
C-Dental X-Ray Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

317 N El Camino Real
Ste 301
Encinitas, CA 92024
Phone (760) 230-1200

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1104286996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 SUTTER ST",
            "address_2": "STE. 1542",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941084206",
            "telephone_number": "415-421-1389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 N EL CAMINO REAL",
            "address_2": "STE. 301",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920242811",
            "telephone_number": "760-942-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCORMACK DENTAL IMAGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-421-1389",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DLXT"
    },
    "taxonomies": [
        {
            "code": "292200000X",
            "taxonomy_group": "",
            "desc": "Dental Laboratory",
            "state": "CA",
            "license": "RHP00053519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.