Dexter Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49870 Issued in CA

Legal business name

DEXTER DENTAL GROUP

Practice address

19195 Outer Hwy 18 Suite 201
Apple Valley, CA 92307-9230

Phone

(760) 242-0796

Fax

(760) 946-3814

NPI assigned

Jun 13, 2017

Last updated

Jun 13, 2017By 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

Angelica Chavez, RDA

Title

Assistant

Phone

(760) 242-0697

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1124558143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19195 OUTER HWY 18 STE 201",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072562",
            "telephone_number": "760-242-0796",
            "fax_number": "760-946-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19195 OUTER HWY 18 SUITE 201",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923079230",
            "telephone_number": "760-242-0796",
            "fax_number": "760-946-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "CHAVEZ",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_title_or_position": "ASSISTANT",
        "authorized_official_telephone_number": "760-242-0697",
        "authorized_official_credential": "RDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lindsey Marie Devor
• Emily Rae Devries, BSW
• Nancy R Diaz
• Dilip R Kelekar M D Inc
• Sabrina Marie Dingle
• Son Dinh, PHARMD
• Aashrita Gurram Divakar, MD

• General Practice Dentistry in Apple Valley, CA
• Providers in Apple Valley, 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 13, 2017; 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.