NPIMap

Organization Active NPI

Edith Mora DMD, Inc.

  • General Practice Dentistry
  • Stockton, CA
National Provider Identifier
1245628270
Registry record updated Dec 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
58214 Issued in CA
Legal business name
EDITH MORA DMD, INC.
Practice address
3133 W March LN Ste 1080
Stockton, CA 95219-2360
Phone
(209) 951-4304
NPI assigned
Dec 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2015

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

Authorized official

Name
Dr. Edith Ivonne Mora, D.M.DNPI 1720047608
Title
Dentist
Phone
(209) 462-2452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 58214 CA Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 53470 CA

Addresses

Primary practice location

3133 W March LN Ste 1080
Stockton, CA 95219-2360

Mailing address

3133 W March LN Ste 1080
Stockton, CA 95219-2360
Phone (209) 951-4304

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1419811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449014400000",
    "number": "1245628270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN STE 1080",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192360",
            "telephone_number": "209-951-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3133 W MARCH LN STE 1080",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952192360",
            "telephone_number": "209-951-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDITH MORA DMD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-29",
        "last_updated": "2015-12-02",
        "status": "A",
        "authorized_official_last_name": "MORA",
        "authorized_official_first_name": "EDITH",
        "authorized_official_middle_name": "IVONNE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "209-462-2452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "58214",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; 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.