Jorge Enciso, DDS, Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JORGE ENCISO, DDS, INC.

Practice address

34366 Yucaipa Blvd Ste K
Yucaipa, CA 92399-2497

Phone

(909) 797-9247

Fax

(909) 797-8587

NPI assigned

Jun 23, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jorge Enciso, DDSNPI 1194374439

Title

Dentist

Phone

(909) 910-5824

Specialties & licenses 1

Addresses

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jorge Enciso, DDS

  • General Practice Dentistry
  • Riverside, CA
  • NPI 1194374439
  NPD Authorized official
• Neal Antonio Johnson, DDS

  • Dental Anesthesiology
  • Yucaipa, CA
  • NPI 1043474471
  NPD
• Glenn Wesley Stevens

  • Dentist
  • Riverside, CA
  • NPI 1124154513
  NPD (past)

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

{
    "created_epoch": "1624406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624406400000",
    "number": "1447829338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13554 DOUGLAS ST",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923995517",
            "telephone_number": "909-910-5824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34366 YUCAIPA BLVD STE K",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923992497",
            "telephone_number": "909-797-9247",
            "fax_number": "909-797-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORGE ENCISO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-23",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A",
        "authorized_official_last_name": "ENCISO",
        "authorized_official_first_name": "JORGE",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "909-910-5824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naudiya Y Jones
• Rachel Moriah Jones, LCSW
• Walter Jones III, M.D.
• Jordan River Physical Therapy
• Jordan River Physical Therapy Inc
• Michael Judah
• Julian M. Tudose, DDS, Inc
• Juniper Manor, LLC
• Avneet Kaur, MD
• Shannon Briana Kearns, FNP-C

• Dental Clinic/Center in Yucaipa, CA
• Providers in Yucaipa, 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 Jun 23, 2021; 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.