NPIMap

Organization Active NPI

Black and to Dental Corporation

  • Dentist
  • Redondo Beach, CA
National Provider Identifier
1124384417
Registry record updated May 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
53880 Issued in CA
Legal business name
BLACK AND TO DENTAL CORPORATION
Practice address
1509 Hawthorne Blvd
Suite 102
Redondo Beach, CA 90278-3957
Phone
(310) 376-5252
Fax
(310) 376-5757
NPI assigned
Apr 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2022

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

Authorized official

Name
Dr. Joan Thanh ToNPI 1609974161
Title
DDS-Owner
Phone
(310) 376-5252

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 53880 CA Primary

Addresses

Primary practice location

1509 Hawthorne Blvd
Suite 102
Redondo Beach, CA 90278-3957

Mailing address

PO Box 920050
Dallas, TX 75392-0050
Phone (714) 368-2077

Other names 1

  • Beach City Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

1509 Hawthorne Blvd
Ste 102
Redondo Beach, CA 90278
Phone (310) 376-5252

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1124384417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-368-2077",
            "fax_number": "714-368-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 HAWTHORNE BLVD",
            "address_2": "SUITE 102",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783957",
            "telephone_number": "310-376-5252",
            "fax_number": "310-376-5757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK AND TO DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A",
        "authorized_official_last_name": "TO",
        "authorized_official_first_name": "JOAN",
        "authorized_official_middle_name": "THANH",
        "authorized_official_title_or_position": "DDS-OWNER",
        "authorized_official_telephone_number": "310-376-5252",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "53880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beach City Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beach City Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.