California Dental Surgery Centers, Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

APLLYING FOR NOW Issued in CA

Legal business name

CALIFORNIA DENTAL SURGERY CENTERS, INC

Practice address

906 S Grand Ave
Glendora, CA 91740-4808

Phone

(626) 852-9500

Fax

(909) 949-6919

NPI assigned

Jul 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Leonard N Ed Miller I, FACHE, MBA

Title

President

Phone

(909) 261-8503

Specialties & licenses 1

Addresses

Other names 1

• glendora dental surgery center Doing business as

Locations

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1245260421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 SOUTH GRAND AVENUE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404808",
            "telephone_number": "626-852-9500",
            "fax_number": "909-949-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404808",
            "telephone_number": "626-852-9500",
            "fax_number": "909-949-6919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALIFORNIA DENTAL SURGERY CENTERS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "N ED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-261-8503",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "FACHE,  MBA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "APLLYING FOR NOW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "glendora dental surgery center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Glendora, CA
• Providers in Glendora, 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 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.