NPIMap

Organization Active NPI

Today Dental Office

  • Dental Clinic/Center
  • Riverside, CA
National Provider Identifier
1114053824
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
39461 Issued in CA
Legal business name
TODAY DENTAL OFFICE
Practice address
4000 Tyler St
Riverside, CA 92503-3402
Phone
(951) 687-4155
NPI assigned
Feb 26, 2007
Last updated
Jul 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Dr. Stacy Mai Pham, D.D.S.NPI 1063420255
Title
Dentist Owner
Phone
(951) 687-4155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 39461 CA Primary

Addresses

Primary practice location

4000 Tyler St
Riverside, CA 92503-3402

Mailing address

4000 Tyler St
Riverside, CA 92503-3402
Phone (951) 687-4155

National Provider Directory

National Provider Directory

Locations

4000 Tyler St
Riverside, CA 92503
Phone (951) 687-4155

Practitioners & affiliated clinicians

Practitioners 1

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": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1114053824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033402",
            "telephone_number": "951-687-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 TYLER ST",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033402",
            "telephone_number": "951-687-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODAY DENTAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "PHAM",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "MAI",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "951-687-4155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "39461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.