NPIMap

Organization Active NPI

Loma Linda University

  • Dental Clinic/Center
  • Loma Linda, CA
National Provider Identifier
1154533826
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LOMA LINDA UNIVERSITY
Practice address
11092 Anderson Street
Room 1147
Loma Linda, CA 92350
Phone
(909) 558-4611
Fax
(909) 558-0106
NPI assigned
May 4, 2007
Last updated
Mar 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Authorized official

Name
Mr. Rodney Dale Neal
Title
Vice President
Phone
(909) 558-4543

Specialties & licenses 1

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

Addresses

Primary practice location

11092 Anderson Street
Room 1147
Loma Linda, CA 92350

Mailing address

11092 Anderson St
Llu Special Care Dentistry
Loma Linda, CA 92350-1706
Phone (909) 558-4375

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154533826. Details of each certification follow.

Ambulatory surgical center certification: CCN 05C0001889

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
LOMA LINDA UNIVERSITY SPECIAL CARE DENTISTRY
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 29, 2009
Last certification
Jun 25, 2021
Ownership / control type
Non-Profit
Facility address
11092 Anderson Street
Loma Linda, CA 92350

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda University School of Dentistry20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

11092 Anderson St
Rm 1147
Loma Linda, CA 92350
Phone (909) 558-4611

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1154533826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON ST",
            "address_2": "LLU SPECIAL CARE DENTISTRY",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501706",
            "telephone_number": "909-558-4375",
            "fax_number": "909-558-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON STREET",
            "address_2": "ROOM 1147",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92350",
            "telephone_number": "909-558-4611",
            "fax_number": "909-558-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "909-558-4543",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loma Linda, CA

Sources for this page

Verify at the official NPI Registry.