St Moises Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

46064 Issued in CA

Legal business name

ST MOISES DENTAL

Practice address

12 Rancho Camino Dr Ste 102
Pomona, CA 91766-7008

Phone

(909) 865-8500

NPI assigned

Jul 26, 2008

Organization subpart

No

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

Authorized official

Name

Ublester Gomez, DDSNPI 1386770568

Title

President/Owner

Phone

(909) 865-8500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Ublester Gomez, DDS

  • General Practice Dentistry
  • Pomona, CA
  • NPI 1386770568
  NPD (past) Authorized official
• Nelson Gomez Jr., PHD

  • Rehabilitation Counselor
  • Pomona, CA
  • NPI 1326289828
  NPD (past)

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

{
    "created_epoch": "1217030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217030400000",
    "number": "1285899443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 RANCHO CAMINO DR STE 102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667008",
            "telephone_number": "909-865-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 RANCHO CAMINO DR STE 102",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917667008",
            "telephone_number": "909-865-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MOISES DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-26",
        "last_updated": "2008-07-26",
        "status": "A",
        "authorized_official_last_name": "GOMEZ",
        "authorized_official_first_name": "UBLESTER",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "909-865-8500",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pallavi Sripathi
• Aditya Kumar Sriram
• Amay Srivastava
• Ananta Srivastava
• St John Community Health Center
• Tyler Scot St. Clair
• St. Joseph Health System Home Care Services LLC
• St. Joseph-Christopher Aquinas Detox Center
• St. Luke University
• Kristian Paolo Roxas Sta Ana, RPH

• General Practice Dentistry in Pomona, CA
• Providers in Pomona, 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 Jul 26, 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.