Johnson & Rollolazo, a Professional Corporation

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

54070 Issued in CA

Legal business name

JOHNSON & ROLLOLAZO, A PROFESSIONAL CORPORATION

Doing business as

Talega Coast Dentistry

Practice address

1031 Avenida Pico Ste 203
San Clemente, CA 92673-6356

Phone

(949) 361-6900

NPI assigned

Nov 12, 2014

Last updated

Nov 12, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dean Rollolazo, R.D.H.

Title

Ceo/Business Manager

Phone

(206) 351-6252

Specialties & licenses 1

Addresses

Other names 1

• Talega Coast Dentistry Doing business as

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

{
    "created_epoch": "1415750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415750400000",
    "number": "1316343742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 AVENIDA PICO STE 203",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736356",
            "telephone_number": "949-361-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 AVENIDA PICO STE 203",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736356",
            "telephone_number": "949-361-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON & ROLLOLAZO, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-12",
        "last_updated": "2014-11-12",
        "status": "A",
        "authorized_official_last_name": "ROLLOLAZO",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "CEO/BUSINESS MANAGER",
        "authorized_official_telephone_number": "206-351-6252",
        "authorized_official_credential": "R.D.H."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "54070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Talega Coast Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monica Lea Jessen, SLP
• Jungyeon Jin, RPH
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• John R Gorny MD Inc
• John Vogt Chiropractic Inc.
• Eric Scott Johnson, DDS
• Evelyn M Johnson, DO
• James Robert Johnson, M.D.
• Martin Arthur Johnson, M.D.
• Raymon Tyler Johnson, D.C.

• Dental Clinic/Center in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.