Inland Empire Oral and Maxillofacial Surgeons

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

73 Issued in CA

Legal business name

INLAND EMPIRE ORAL AND MAXILLOFACIAL SURGEONS

Practice address

8112 Milliken Ave
102
Rancho Cucamonga, CA 91730-7471

Phone

(909) 581-7761

Fax

(909) 581-7766

NPI assigned

May 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Edward Dudziak, DDS, MDNPI 1922128321

Title

President

Phone

(909) 581-7761

Specialties & licenses 1

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Matthew Edward Dudziak, DDS MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Rancho Cucamonga, CA
  • NPI 1922128321
  NPD (past) Authorized official
• Christopher Choi, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Rancho Cucamonga, CA
  • NPI 1326214941
  NPD (past)
• Bruce F Hicke, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Montclair, CA
  • NPI 1982736815
  NPD (past)

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1245497932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE",
            "address_2": "102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307471",
            "telephone_number": "909-581-7761",
            "fax_number": "909-581-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8112 MILLIKEN AVE",
            "address_2": "102",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307471",
            "telephone_number": "909-581-7761",
            "fax_number": "909-581-7766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE ORAL AND MAXILLOFACIAL SURGEONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "DUDZIAK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-581-7761",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Inland Empire Extra Care
• Inland Empire Extra Care Inc.
• Inland Empire Health Plan
• Inland Empire Medical Nertwork, Inc.
• Inland Empire Medical Network (Chaffey Medical Group)
• Inland Empire Senior Services (Senior Helpers)
• Inland Empire Senior Services Inc (Senior Helpers)
• Inland Empire Sleep Medicine
• Inland Empire Surgical Group, LLC
• Inland Home Health Providers, Inc.

• Oral and Maxillofacial Surgery (Dentist) in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.