Dr Jandali Dental Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46833 Issued in CA

Legal business name

DR JANDALI DENTAL INC.

Practice address

9353 Fairway View PL
200
Rancho Cucamonga, CA 91730-0961

Phone

(909) 987-9933

Fax

(909) 581-6669

NPI assigned

Oct 9, 2013

Organization subpart

No

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

Authorized official

Name

Azza Jandali, DDS

Title

Dentist

Phone

(909) 987-9933

Specialties & licenses 1

Addresses

Other names 1

• Horizons dental practice Doing business as

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1205263191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9353 FAIRWAY VIEW PL",
            "address_2": "200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300961",
            "telephone_number": "909-987-9933",
            "fax_number": "909-581-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9353 FAIRWAY VIEW PL",
            "address_2": "200",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917300961",
            "telephone_number": "909-987-9933",
            "fax_number": "909-581-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR JANDALI DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "JANDALI",
        "authorized_official_first_name": "AZZA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "909-987-9933",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Horizons dental practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Dec 31, 2013; 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.