Gomes Tobon Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63324 Issued in CA

Legal business name

GOMES TOBON DENTAL CORPORATION

Practice address

2690 Pacific Ave
Suite 250
Long Beach, CA 90806-2657

Phone

(310) 936-6517

Fax

(562) 317-5260

NPI assigned

May 11, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Cleber Januario Gomes, CCS

Title

President

Phone

(310) 936-6517

Specialties & licenses 1

Addresses

Other names 1

• CDI Dental Group Doing business as

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1285160093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 PACIFIC AVE",
            "address_2": "SUITE 250",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "90806",
            "telephone_number": "310-936-6517",
            "fax_number": "562-317-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 PACIFIC AVE",
            "address_2": "SUITE 250",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908062657",
            "telephone_number": "310-936-6517",
            "fax_number": "562-317-5260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOMES TOBON DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "CLEBER",
        "authorized_official_middle_name": "JANUARIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-936-6517",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CCS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDI Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Barry Bardia Golestany
• Michelle Golland, PSY.D.
• Azadeh Golshani, M.S.
• Christopher Golveo
• Lee M Gomberg, PH.D.
• Cleber Januario Gomes, DDS
• Donna Rose Gomes, RRW
• Shane Lex Gomes, PH.D.
• Brittney Gomez Jimenez
• Lucylibeth Claudia Gomez Marroquin

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, 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 May 11, 2017; 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.