NPIMap

Organization Active NPI

Dimitri Dental Corporation

Doing business as Gateway Dental Group

  • General Practice Dentistry
  • Mira Loma, CA
National Provider Identifier
1346349685
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DIMITRI DENTAL CORPORATION
Doing business as
Gateway Dental Group
Gateway Dental Group and Orthodontics
Practice address
12571 Limonite Ave
Ste. 230
Mira Loma, CA 91752-3676
Phone
(951) 360-3444
Fax
(951) 360-3484
NPI assigned
Sep 22, 2006
Last updated
Oct 7, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Authorized official

Name
Dr. Rami Dimitri, DDSNPI 1770756959
Title
Owner
Phone
(951) 360-3444

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

12571 Limonite Ave
Ste. 230
Mira Loma, CA 91752-3676

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 2

  • Gateway Dental Group Doing business as
  • Gateway Dental Group and Orthodontics Doing business as

National Provider Directory

National Provider Directory

Locations

12571 Limonite Ave
Ste 230
Eastvale, CA 91752
Phone (951) 360-3444

Practitioners & affiliated clinicians

Practitioners 4

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": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1346349685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12571 LIMONITE AVE",
            "address_2": "STE. 230",
            "city": "MIRA LOMA",
            "state": "CA",
            "postal_code": "917523676",
            "telephone_number": "951-360-3444",
            "fax_number": "951-360-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMITRI DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "DIMITRI",
        "authorized_official_first_name": "RAMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-360-3444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gateway Dental Group and Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mira Loma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.