NPIMap

Organization Active NPI

Feldkamp Cal Select Dental Group, Inc.

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1295213239
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21985 Issued in CA
Legal business name
FELDKAMP CAL SELECT DENTAL GROUP, INC.
Practice address
164 W Hospitality LN # 107
San Bernardino, CA 92408-3316
Phone
(909) 453-6600
NPI assigned
Aug 1, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Authorized official

Name
Mr. Irving Moore Feldkamp III, DDS
Title
President
Phone
(909) 723-1088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 21985 CA Primary

Addresses

Primary practice location

164 W Hospitality LN # 107
San Bernardino, CA 92408-3316

Mailing address

PO Box 10669
San Bernardino, CA 92423-0669
Phone (909) 723-1088

Other names 1

  • Cal Select Dental Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Feldkamp Cal Select Dental Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

164 W Hospitality Ln
Ste 107
San Bernardino, CA 92408
Phone (909) 453-6600

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533081600000",
    "number": "1295213239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10669",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924230669",
            "telephone_number": "909-723-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN # 107",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083316",
            "telephone_number": "909-453-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELDKAMP CAL SELECT DENTAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2018-08-01",
        "status": "A",
        "authorized_official_last_name": "FELDKAMP",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-723-1088",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cal Select Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; 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.