NPIMap

Organization Active NPI

Phillips Ranch Dental Group

  • Dentist
  • Phillips Ranch, CA
National Provider Identifier
1427201151
Registry record updated Oct 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
24452 Issued in CA
Legal business name
PHILLIPS RANCH DENTAL GROUP
Practice address
4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891
Phone
(909) 620-0321
Fax
(909) 620-0324
NPI assigned
Oct 28, 2008
Last updated
Oct 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2008

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

Authorized official

Name
Mrs. Jodie Ann Ramirez
Title
Executive Director
Phone
(909) 620-0321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 24452 CA Primary

Addresses

Primary practice location

4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891

Mailing address

4 Village Loop Rd
B2
Phillips Ranch, CA 91766-4891

National Provider Directory

National Provider Directory
Tax ID family
Phillips Ranch Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4 Village Loop Rd
#B2
Phillips Ranch, CA 91766
Phone (909) 620-0321

NPI Registry JSON

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1427201151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 VILLAGE LOOP RD",
            "address_2": "B2",
            "city": "PHILLIPS RANCH",
            "state": "CA",
            "postal_code": "917664891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 VILLAGE LOOP RD",
            "address_2": "B2",
            "city": "PHILLIPS RANCH",
            "state": "CA",
            "postal_code": "917664891",
            "telephone_number": "909-620-0321",
            "fax_number": "909-620-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILLIPS RANCH DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-28",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "RAMIREZ",
        "authorized_official_first_name": "JODIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "909-620-0321",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "24452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phillips Ranch, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.