Beatriz Vidales DDS Orthodontics, Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

45212 Issued in CA

Legal business name

BEATRIZ VIDALES DDS ORTHODONTICS, INC

Practice address

744 Grand Ave
San Marcos, CA 92078-1225

Phone

(760) 744-0004

Fax

(760) 744-0001

NPI assigned

Oct 30, 2015

Organization subpart

No

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

Authorized official

Name

Beatriz Vidales

Title

Dentist

Phone

(760) 744-0004

Specialties & licenses 1

Addresses

Other names 1

• Ortho Smile Doing business as

Locations

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446163200000",
    "number": "1447622329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 GRAND AVE",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781225",
            "telephone_number": "760-744-0004",
            "fax_number": "760-744-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "744 GRAND AVE",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920781225",
            "telephone_number": "760-744-0004",
            "fax_number": "760-744-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEATRIZ VIDALES DDS ORTHODONTICS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-30",
        "last_updated": "2015-10-30",
        "status": "A",
        "authorized_official_last_name": "VIDALES",
        "authorized_official_first_name": "BEATRIZ",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "760-744-0004"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "45212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ortho Smile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gabriella Baumer
• Idalia Bautista Ramos
• Mark Tyler Bautista, DPT
• Mia Bautista
• Meenu Bawa, M.D
• Robert L Beavers, DMD
• Fernando Becerra Jr.
• Yasmin Yadira Bedoy Carrillo
• Brandon Behar, MA, AMFT, APCC
• Tanya Marie Belanger, CNM

• Preferred Provider Organization in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2015; 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.