NPIMap

Organization Active NPI

Antioquia Dental Care, Inc.

  • Dentist
  • National City, CA
National Provider Identifier
1376774349
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
25111 Issued in CA
Legal business name
ANTIOQUIA DENTAL CARE, INC.
Practice address
1727 Sweetwater Road, Suite Q
National City, CA 91950
Phone
(619) 477-0045
Fax
(619) 477-5822
NPI assigned
Aug 7, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Authorized official

Name
Dr. Benjamin Salvador Antioquia, D.D.S.
Title
President
Phone
(619) 477-0045

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 25111 CA Primary

Addresses

Primary practice location

1727 Sweetwater Road, Suite Q
National City, CA 91950

Mailing address

1727 Sweetwater Road, Suite Q
National City, CA 91950
Phone (619) 477-0045

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1249603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1376774349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1727 SWEETWATER ROAD, SUITE Q",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "91950",
            "telephone_number": "619-477-0045",
            "fax_number": "619-477-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1727 SWEETWATER ROAD, SUITE Q",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "91950",
            "telephone_number": "619-477-0045",
            "fax_number": "619-477-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTIOQUIA DENTAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-07",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "ANTIOQUIA",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "SALVADOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-477-0045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "25111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in National City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.