Socal Dental Specialists Dental Group of Dr. Ummethala

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

SOCAL DENTAL SPECIALISTS DENTAL GROUP OF DR. UMMETHALA

Practice address

1460 Ford St.
Ste 105
Redlands, CA 92373

Phone

(909) 500-2705

Fax

(909) 500-3930

NPI assigned

Jun 14, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Kitichai Rungcharassaeng, DDS

Title

Orthodontist

Phone

(909) 500-2705

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1407530918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 FORD ST.",
            "address_2": "STE 105",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-500-2705",
            "fax_number": "909-500-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 FORD ST.",
            "address_2": "STE 105",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-500-2705",
            "fax_number": "909-500-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOCAL DENTAL SPECIALISTS DENTAL GROUP OF DR. UMMETHALA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A",
        "authorized_official_last_name": "RUNGCHARASSAENG",
        "authorized_official_first_name": "KITICHAI",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "909-500-2705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie L. Snyder, M.D.
• Lauren Snyder, PSYD
• Lynda L. Snyder, M.F.T.
• Soaring Families Counseling Inc
• Marian Rose Sobretodo, FNP-C
• Socal Specialty Care Medical Corporation
• Socalhealth Inc. Ipa
• Soda Dental Hygiene Practice of Ashley Shelley Rdhap, Inc.
• Soeprono Medical Corporation
• Albert I Sofyan

• Orthodontics and Dentofacial Orthopedics Dentistry in Redlands, CA
• Providers in Redlands, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 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.

Verify at the official NPI Registry.