Dr Gray Orthodontic Specialists

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DR GRAY ORTHODONTIC SPECIALISTS

Practice address

436 N Mountain Ave
Upland, CA 91786-5117

Phone

(909) 981-2025

Fax

(909) 920-0398

NPI assigned

Sep 18, 2024

Last updated

Sep 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cindi Debenedetto

Title

Financial Coordinator

Phone

(909) 981-2025

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vanessa Noel Browne Peterson, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rancho Cucamonga, CA
  • NPI 1912348145
  NPD (past)

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1225865777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865117",
            "telephone_number": "909-981-2025",
            "fax_number": "909-920-0398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N MOUNTAIN AVE",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917865117",
            "telephone_number": "909-981-2025",
            "fax_number": "909-920-0398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR GRAY ORTHODONTIC SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "DEBENEDETTO",
        "authorized_official_first_name": "CINDI",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "909-981-2025"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas J Beseth MD a Medical Corporation
• Amber C Douglas
• Dover Home Health Care, Inc.
• Lauren Michelle Dowell
• James Andrew Doyle, MS
• Dr Kevin M Jenkins DO Inc
• Dr Tanya Optometry (Mintz Family Optometry)
• Dr. Aram Yeliazyan DDS
• Dr. Kim Optometry Upland Inc
• Dr. Nancy Wang, OD, Inc.

• Dental Clinic/Center in Upland, CA
• Providers in Upland, 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 Sep 18, 2024; 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.