Organization Active NPI

Carmy Michael, DDS Corp.

Doing business as Dental Care of Rialto

  • General Practice Dentistry
  • Rialto, CA
National Provider Identifier
1376021576
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CARMY MICHAEL, DDS CORP.
Doing business as
Dental Care of Rialto
Practice address
1817 N Riverside Ave
Rialto, CA 92376-8069
Phone
(909) 879-1024
NPI assigned
Jul 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Authorized official

Name
Dr. Carmy Gabriel Michael, DDS
Title
Ceo
Phone
(714) 874-6069

Specialties & licenses 1

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

Addresses

Primary practice location

1817 N Riverside Ave
Rialto, CA 92376-8069

Mailing address

1817 N Riverside Ave
Rialto, CA 92376-8069
Phone (909) 879-1024

Other identifiers 2

IdentifierTypeStateIssuer
1730216599MedicaidMI
12-4767679MedicaidMI

Other names 1

  • Dental Care of Rialto Doing business as

National Provider Directory

National Provider Directory

Locations

1817 N Riverside Ave
Rialto, CA 92376
Phone (909) 879-1024

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.

NPI Registry JSON

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720742400000",
    "number": "1376021576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1817 N RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768069",
            "telephone_number": "909-879-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 N RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923768069",
            "telephone_number": "909-879-1024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARMY MICHAEL, DDS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-31",
        "last_updated": "2024-07-12",
        "certification_date": "2024-06-29",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "CARMY",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "714-874-6069",
        "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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1730216599",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12-4767679",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Care of Rialto",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dental Care of Rialto",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; 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.