International Dental Providers Corp.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

512443 Issued in ZZ

Legal business name

INTERNATIONAL DENTAL PROVIDERS CORP.

Practice address

1594 Woodlark CT
Chula Vista, CA 91911-5321

Phone

(619) 691-8180

Fax

(619) 691-1201

NPI assigned

Aug 11, 2008

Last updated

Aug 11, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Angel Serrano, DDS

Title

Owner

Phone

(619) 691-8180

Specialties & licenses 1

Addresses

Other identifiers 9

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1396991295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1594 WOODLARK CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919115321",
            "telephone_number": "619-691-8180",
            "fax_number": "619-691-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1594 WOODLARK CT",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919115321",
            "telephone_number": "619-691-8180",
            "fax_number": "619-691-1201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNATIONAL DENTAL PROVIDERS CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-11",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "SERRANO",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-691-8180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ZZ",
            "license": "512443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HEALTH SERVICES OF CALIFORNIA",
            "identifier": "104",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WESTERN DENTAL SERVICES, INC",
            "identifier": "1369",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LIBERTY DENTAL PLANS OF CALIFORNIA",
            "identifier": "4048",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC UNION DENTAL, INC",
            "identifier": "325977",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD HEALTH PLANS, INC.",
            "identifier": "1141",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DENTAL NETWORK, INC",
            "identifier": "1327",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GOLDEN WEST HEALTH PLANS, INC",
            "identifier": "1185",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC",
            "identifier": "351398",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE DENTAL & VISION ADMINISTRATORS",
            "identifier": "44010",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Innova Nuring Services LLC
• Innovative Dialysis Centers of la Jolla LLC (U.S. Renal Care Chula Vista Home Dialysis)
• Innovative Dialysis Centers of la Jolla LLC (U.S. Renal Care Chula Vista Dialysis)
• Maria Inostroz
• Inspiration PT
• Brianna Lynn Introcaso, BS, DPT
• Valentina Inurreta
• Alba Inzunza
• Colin Siu-Tak Ip, MD
• Gordon Ip, DPT

• Dental Clinic/Center in Chula Vista, CA
• Providers in Chula Vista, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2008; 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.