Adriana Thomas Professional Dental Corp

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34296 Issued in CA

Legal business name

ADRIANA THOMAS PROFESSIONAL DENTAL CORP

Practice address

1120 Via Verde
San Dimas, CA 91773

Phone

(909) 599-2444

Fax

(909) 599-2024

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Adriana Thomas, DDS

Title

President Owner

Phone

(909) 594-2444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Plaza Dental Office Other name

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1114136827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 VIA VERDE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "91773",
            "telephone_number": "909-599-2444",
            "fax_number": "909-599-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 VIA VERDE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "91773",
            "telephone_number": "909-599-2444",
            "fax_number": "909-599-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIANA THOMAS PROFESSIONAL DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "909-594-2444",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "F9179901",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza Dental Office",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in San Dimas, CA
• Providers in San Dimas, 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 Jun 22, 2010; 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.