Atienza Family Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

40786 Issued in CA

Legal business name

ATIENZA FAMILY DENTAL CORPORATION

Practice address

37070 Newark Blvd Ste C
Newark, CA 94560-3798

Phone

(510) 793-2665

Fax

(510) 793-2695

NPI assigned

May 2, 2011

Last updated

May 2, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Regis M Atienza Jr., DMD

Title

Owner

Phone

(510) 205-6151

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1124319652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37070 NEWARK BLVD STE C",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603798",
            "telephone_number": "510-793-2665",
            "fax_number": "510-793-2695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37070 NEWARK BLVD STE C",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "945603798",
            "telephone_number": "510-793-2665",
            "fax_number": "510-793-2695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATIENZA FAMILY DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "ATIENZA",
        "authorized_official_first_name": "REGIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-205-6151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "40786",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Newark, CA
• Providers in Newark, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.