Active NPI
David M. Diaz Dental Corporation
Doing business as Redlands Childrens Dental Group
- Pediatric Dentistry
- Redlands, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 30642
- Legal business name
- DAVID M. DIAZ DENTAL CORPORATION
- Doing business as
- Redlands Childrens Dental Group
- Practice address
- 308 W State St Ste 4a
Redlands, CA 92373-4626 - Phone
- (909) 798-2755
- Fax
- (909) 307-2098
- NPI assigned
- Apr 16, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David M Diaz, D.D.S.
- Title
- Owner
- Phone
- (909) 798-2755
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 30642 | CA | Primary |
Addresses
Primary practice location
308 W State St Ste 4a
Redlands, CA 92373-4626
Mailing address
1801 Newport Blvd
Costa Mesa, CA 92627
Phone (949) 548-5588
Other names 1
- Redlands Childrens Dental Group
National Provider Directory
National Provider DirectoryLocations
1801 Newport Blvd
Costa Mesa, CA 92627
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.
-
- General Practice Dentistry
- Costa Mesa, CA
- NPI 1699882498
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1190160000000",
"number": "1346465317",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1801 NEWPORT BLVD",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "92627",
"telephone_number": "949-548-5588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "308 W STATE ST STE 4A",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923734626",
"telephone_number": "909-798-2755",
"fax_number": "909-307-2098"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAVID M. DIAZ DENTAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-04-16",
"last_updated": "2007-09-19",
"status": "A",
"authorized_official_last_name": "DIAZ",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "909-798-2755",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "30642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Redlands Childrens Dental Group",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.