Caring Family Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

40976 Issued in CA

Legal business name

CARING FAMILY DENTISTRY

Practice address

1063 N D St
San Bernardino, CA 92410-3539

Phone

(909) 888-5499

Fax

(909) 888-5611

NPI assigned

Aug 3, 2012

Organization subpart

No

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

Authorized official

Name

Tina Mieun Park-Lee, DDS

Title

Owner/Partner

Phone

(909) 888-5499

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1343952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343952000000",
    "number": "1437406873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1063 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103539",
            "telephone_number": "909-888-5499",
            "fax_number": "909-888-5611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1063 N D ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103539",
            "telephone_number": "909-888-5499",
            "fax_number": "909-888-5611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARING FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-03",
        "last_updated": "2012-08-03",
        "status": "A",
        "authorized_official_last_name": "PARK-LEE",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "MIEUN",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "909-888-5499",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "40976",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "36091",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G9164701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2012; 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.