Active NPI
Petros Toma & Putrus Dental Corp
- Dentist
- San Diego, CA
National Provider Identifier
1104988088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48043
- Legal business name
- PETROS TOMA & PUTRUS DENTAL CORP
- Practice address
- 4844 University Avenue
Suite B
San Diego, CA 92105 - Phone
- (619) 285-5010
- Fax
- (619) 285-5013
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Omeed Butrus Toma, DDS
- Title
- Associate Dentist Partner
- Phone
- (619) 285-5010
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 48043 | CA | Primary |
Addresses
Primary practice location
4844 University Avenue
Suite B
San Diego, CA 92105
Mailing address
4844 University Avenue
Suite B
San Diego, CA 92105
Phone (619) 285-5010
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D48043 | Other | CA | DENTICAL |
National Provider Directory
National Provider Directory- Tax ID family
- Petros Toma Putrus Dental Corp
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- San Diego, CA
- NPI 1548320849
Locations
4844 University Ave
Ste B
San Diego, CA 92105
Phone (619) 258-5010
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dentist
- San Diego, CA
- NPI 1346451812
-
- Dentist
- La Mesa, CA
- NPI 1124474911
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1104988088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4844 UNIVERSITY AVENUE",
"address_2": "SUITE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92105",
"telephone_number": "619-285-5010",
"fax_number": "619-285-5013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4844 UNIVERSITY AVENUE",
"address_2": "SUITE B",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "92105",
"telephone_number": "619-285-5010",
"fax_number": "619-285-5013"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PETROS TOMA & PUTRUS DENTAL CORP",
"organizational_subpart": "NO",
"enumeration_date": "2006-12-15",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "TOMA",
"authorized_official_first_name": "OMEED",
"authorized_official_middle_name": "BUTRUS",
"authorized_official_title_or_position": "ASSOCIATE DENTIST PARTNER",
"authorized_official_telephone_number": "619-285-5010",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dentist",
"state": "CA",
"license": "48043",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "D48043",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.