NPIMap

Organization Active NPI

Juan Antonio Trejo Canchola Dental Corporation

  • Point of Service
  • Riverside, CA
National Provider Identifier
1215344783
Registry record updated Jul 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
61049 Issued in CA
Legal business name
JUAN ANTONIO TREJO CANCHOLA DENTAL CORPORATION
Practice address
9867 Magnolia Ave Ste E
Riverside, CA 92503-3519
Phone
(951) 352-2112
Fax
(951) 352-2088
NPI assigned
Jul 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2014

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

Authorized official

Name
Dr. Juan Antonio T. Trejo Canchola, DDS
Title
Managing Dentist
Phone
(951) 842-0803

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 61049 CA Primary

Addresses

Primary practice location

9867 Magnolia Ave Ste E
Riverside, CA 92503-3519

Mailing address

9867 Magnolia Ave Ste E
Riverside, CA 92503-3519
Phone (951) 352-2112

National Provider Directory

National Provider Directory
Tax ID family
Juan Antonio Trejo Canchola Dental Corp2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

9867 Magnolia Ave
Ste E
Riverside, CA 92503
Phone (951) 352-2112

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405468800000",
    "number": "1215344783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9867 MAGNOLIA AVE STE E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033519",
            "telephone_number": "951-352-2112",
            "fax_number": "951-352-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9867 MAGNOLIA AVE STE E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033519",
            "telephone_number": "951-352-2112",
            "fax_number": "951-352-2088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN ANTONIO TREJO CANCHOLA DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2014-07-16",
        "status": "A",
        "authorized_official_last_name": "TREJO CANCHOLA",
        "authorized_official_first_name": "JUAN ANTONIO",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "MANAGING DENTIST",
        "authorized_official_telephone_number": "951-842-0803",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "61049",
            "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 Jul 16, 2014; 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.