Sandy Inton Dizon Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

53059 Issued in CA

Practice address

9640 Milliken Ave
Suite 104
Rancho Cucamonga, CA 91730-9000

Phone

(909) 476-2821

Fax

(909) 476-2805

NPI assigned

Jan 25, 2017

Last updated

Jan 25, 2017By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sandy I Dizon Jr, DDS, Inc

  • General Practice Dentistry
  • Rancho Cucamonga, CA
  • NPI 1255865705
  NPD (past) Authorized official

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

{
    "created_epoch": "1485302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485302400000",
    "number": "1346787561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9640 MILLIKEN AVE",
            "address_2": "SUITE 104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309000",
            "telephone_number": "909-476-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 MILLIKEN AVE",
            "address_2": "SUITE 104",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309000",
            "telephone_number": "909-476-2821",
            "fax_number": "909-476-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIZON",
        "first_name": "SANDY",
        "middle_name": "INTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-01-25",
        "last_updated": "2017-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divine Insight Family Therapy, Inc.
• Divine Touch Medical Transportation LLC
• Divine Touch Wound Care Inc
• Sarah Dixon
• Lorigrace Dizon, PT
• Borko B Djordjevic, M.D., PHD., F.I.C.S.
• Amy DO, PA-C
• Anthony DO
• Teresa DO
• Justin Doan

• General Practice Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; 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.