Active NPI
Ublester Gomez, DDS
- General Practice Dentistry
- Pomona, CA
National Provider Identifier
1386770568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 46064
- Practice address
- 12 Rancho Camino Dr
Suite # 102
Pomona, CA 91766-7005 - Phone
- (909) 865-8500
- Fax
- (909) 865-8552
- NPI assigned
- Feb 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 46064 | CA | Primary |
Addresses
Primary practice location
12 Rancho Camino Dr
Suite # 102
Pomona, CA 91766-7005
Mailing address
12 Rancho Camino Dr
Suite # 102
Pomona, CA 91766-7005
Phone (909) 865-8500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46064 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Moises Dental | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Pomona, CA
- NPI 1285899443
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1386770568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12 RANCHO CAMINO DR",
"address_2": "SUITE # 102",
"city": "POMONA",
"state": "CA",
"postal_code": "917667005",
"telephone_number": "909-865-8500",
"fax_number": "909-865-8552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12 RANCHO CAMINO DR",
"address_2": "SUITE # 102",
"city": "POMONA",
"state": "CA",
"postal_code": "917667005",
"telephone_number": "909-865-8500",
"fax_number": "909-865-8552"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOMEZ",
"first_name": "UBLESTER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-24",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "46064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pomona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.