NPIMap

Organization Active NPI

Dentireal Inc.

  • Dentist
  • Riverside, CA
National Provider Identifier
1205229234
Registry record updated Mar 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
37337 Issued in CA
Legal business name
DENTIREAL INC.
Practice address
9402 Magnolia Ave
Riverside, CA 92503-3723
Phone
(951) 359-9100
NPI assigned
Mar 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2015

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

Authorized official

Name
Eddy Shea, DDSNPI 1457461691
Title
Owner/President
Phone
(951) 359-9200

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: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 37337 CA Primary

Addresses

Primary practice location

9402 Magnolia Ave
Riverside, CA 92503-3723

Mailing address

9402 Magnolia Ave
Riverside, CA 92503-3723
Phone (951) 359-9100

National Provider Directory

National Provider Directory

Locations

9402 Magnolia Ave
Riverside, CA 92503
Phone (951) 359-9100

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": "1426464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426464000000",
    "number": "1205229234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9402 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033723",
            "telephone_number": "951-359-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9402 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033723",
            "telephone_number": "951-359-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTIREAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-16",
        "last_updated": "2015-03-16",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "EDDY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "951-359-9200",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "37337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.