R Cruz Abaro Dental Corp

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

R CRUZ ABARO DENTAL CORP

Doing business as

San Gabriel Dental & Orthodontics

Practice address

6503 Rosemead Blvd
San Gabriel, CA 91775-1936

Phone

(626) 720-4072

Fax

(626) 286-2598

NPI assigned

Apr 9, 2020

Organization subpart

No

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

Authorized official

Name

Ms. Faviola Silva

Title

Manager

Phone

(323) 835-6839

Specialties & licenses 1

Addresses

Other names 1

• San Gabriel Dental & Orthodontics Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1194344259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6503 ROSEMEAD BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917751936",
            "telephone_number": "626-720-4072",
            "fax_number": "626-286-2598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6503 ROSEMEAD BLVD",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917751936",
            "telephone_number": "626-720-4072",
            "fax_number": "626-286-2598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R CRUZ ABARO DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-09",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "SILVA",
        "authorized_official_first_name": "FAVIOLA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "323-835-6839",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "favi@ourbestlifeinc.com",
            "affiliation": "N",
            "endpointDescription": "office e-mail",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3131 E Florence Ave",
            "city": "Huntington Park",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902555839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "San Gabriel Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in San Gabriel, CA
• Providers in San Gabriel, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.