Viacheslav S. Zoubtsov,D.D.S.,a Professional Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48574 Issued in CA

Legal business name

VIACHESLAV S. ZOUBTSOV,D.D.S.,A PROFESSIONAL DENTAL CORPORATION

Doing business as

prime dental office

Practice address

1049 W Philadelphia St
Ontario, CA 91762-6145

Phone

(909) 391-2324

NPI assigned

Jul 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Viacheslav Zoubtsov, DDS

Title

President

Phone

(626) 201-6278

Specialties & licenses 1

Addresses

Other names 1

• prime dental office Doing business as

Locations

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1295047066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 GREENBOROUGH PL",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917921923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 W PHILADELPHIA ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917626145",
            "telephone_number": "909-391-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIACHESLAV S. ZOUBTSOV,D.D.S.,A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-09",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "ZOUBTSOV",
        "authorized_official_first_name": "VIACHESLAV",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-201-6278",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "prime dental office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Ontario, CA
• Providers in Ontario, 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 9, 2010; 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.