Dental Specialties 2ND Dr, Jesse a Professional Corporation

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

23785 Issued in CA

Legal business name

DENTAL SPECIALTIES 2ND DR, JESSE A PROFESSIONAL CORPORATION

Practice address

15401 Anacapa Rd Ste 3
Victorville, CA 92392-2466

Phone

(760) 951-9304

Fax

(951) 396-3335

NPI assigned

Dec 21, 2016

Organization subpart

No

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

Authorized official

Name

James Jesse

Title

DDS/Owner

Phone

(760) 951-9304

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sobha Allada, DDS

  • General Practice Dentistry
  • Victorville, CA
  • NPI 1558387241
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1285179697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15401 ANACAPA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922466",
            "telephone_number": "760-951-9304",
            "fax_number": "951-396-3335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15401 ANACAPA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922466",
            "telephone_number": "760-951-9304",
            "fax_number": "951-396-3335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALTIES 2ND DR, JESSE A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "JESSE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "760-951-9304"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "23785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deirmenjian Dental Group Inc
• Deirmenjian Dental Group Inc
• Dexter Reyes Dejesus, DDS
• Adriana Delgado
• Jazlyn Naomi Delgado
• Department of Behavioral Health, San Bernardino County Ca
• Tejal Desai
• Desert Bloom Recovery LLC
• Desert Community Hospice, Inc.
• Desert Heart Cardiology and Associates PLC

• Point of Service in Victorville, CA
• Providers in Victorville, CA by specialty
• Point of Service in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.