NPIMap

Organization Active NPI

Demetrio Landeros

  • Oral and Maxillofacial Pathology Dentistry
National Provider Identifier
1245467307
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
MX721191 Issued in ZZ
Legal business name
DEMETRIO LANDEROS
Practice address
Blvd Sanchez Toboada #4002 C-9
Tijuana, BAJA CALIFORNIA 22320
MX
Phone
(619) 734-2358
NPI assigned
Jun 16, 2009
Organization subpart
Yes
Parent organization
AMEXUS DENTAL PPOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Authorized official

Name
Dr. Demetrio Landeros
Title
President
Phone
(619) 734-2358

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X MX721191 ZZ Primary

Addresses

Primary practice location

Blvd Sanchez Toboada #4002 C-9
Tijuana, BAJA CALIFORNIA 22320
MX

Mailing address

Blvd Sanchez Toboada #4002 C-9
Tijuana, BAJA CALIFORNIA 22320
MX
Phone (619) 734-2358

National Provider Directory

National Provider Directory
Tax ID family
Veronica Gonzalez4 organizations share this tax ID, including this one
Part of
Veronica Gonzalez

Other organizations with this tax ID 3

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": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245110400000",
    "number": "1245467307",
    "addresses": [
        {
            "country_code": "MX",
            "country_name": "Mexico",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "BLVD SANCHEZ TOBOADA #4002 C-9",
            "city": "TIJUANA",
            "state": "BAJA CALIFORNIA",
            "postal_code": "22320",
            "telephone_number": "619-734-2358"
        },
        {
            "country_code": "MX",
            "country_name": "Mexico",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "BLVD SANCHEZ TOBOADA #4002 C-9",
            "city": "TIJUANA",
            "state": "BAJA CALIFORNIA",
            "postal_code": "22320",
            "telephone_number": "619-734-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEMETRIO LANDEROS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMEXUS DENTAL PPO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A",
        "authorized_official_last_name": "LANDEROS",
        "authorized_official_first_name": "DEMETRIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-734-2358",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "ZZ",
            "license": "MX721191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; 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.