NPIMap

Organization Active NPI

My Dentist and Me Pediatric Dentistry

  • Pediatric Dentistry
  • Riverside, CA
National Provider Identifier
1295145662
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
61151 Issued in CA
Legal business name
MY DENTIST AND ME PEDIATRIC DENTISTRY
Practice address
5225 Canyon Crest Dr
#309
Riverside, CA 92507-6301
Phone
(712) 574-3307
NPI assigned
May 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Christine Min, DDSNPI 1235113283
Title
Partner
Phone
(712) 574-3307

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
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 61151 CA Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X 56036 CA

Addresses

Primary practice location

5225 Canyon Crest Dr
#309
Riverside, CA 92507-6301

Mailing address

5225 Canyon Crest Dr
#309
Riverside, CA 92507-6301

National Provider Directory

National Provider Directory

Locations

5225 Canyon Crest Dr
Ste 309
Riverside, CA 92507
Phone (712) 574-3307

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1295145662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DR",
            "address_2": "#309",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5225 CANYON CREST DR",
            "address_2": "#309",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076301",
            "telephone_number": "712-574-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DENTIST AND ME PEDIATRIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "MIN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "712-574-3307",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "61151",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "56036",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.