NPIMap

Organization Active NPI

San Antonio Dental Office Elvia Juarez Dental Corp

  • General Practice Dentistry
  • Coachella, CA
National Provider Identifier
1205906872
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41625 Issued in CA
Legal business name
SAN ANTONIO DENTAL OFFICE ELVIA JUAREZ DENTAL CORP
Doing business as
San Antonio Dental Office Elvia Juarez Dental Corp
Practice address
51335 Harrison St
Suite 107
Coachella, CA 92236
Phone
(760) 398-9848
Fax
(760) 398-9877
NPI assigned
Nov 9, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elvia Juarez Mata, DDS
Title
Dentist
Phone
(760) 398-9848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 41625 CA Primary

Addresses

Primary practice location

51335 Harrison St
Suite 107
Coachella, CA 92236

Mailing address

51335 Harrison St
Suite 107
Coachella, CA 92236
Phone (760) 398-9848

Other names 1

  • San Antonio Dental Office Elvia Juarez Dental Corp Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ej Dental6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205906872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51335 HARRISON ST",
            "address_2": "SUITE 107",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "92236",
            "telephone_number": "760-398-9848",
            "fax_number": "760-398-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51335 HARRISON ST",
            "address_2": "SUITE 107",
            "city": "COACHELLA",
            "state": "CA",
            "postal_code": "92236",
            "telephone_number": "760-398-9848",
            "fax_number": "760-398-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN ANTONIO DENTAL OFFICE ELVIA JUAREZ DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JUAREZ MATA",
        "authorized_official_first_name": "ELVIA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "760-398-9848",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Antonio Dental Office Elvia Juarez Dental Corp",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coachella, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.