NPIMap

Organization Active NPI

Elvia Juarez a Dental Corporation

Doing business as EJ Dental

  • General Practice Dentistry
  • Banning, CA
National Provider Identifier
1467226795
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELVIA JUAREZ A DENTAL CORPORATION
Doing business as
EJ Dental
Practice address
3333 W Ramsey St
Banning, CA 92220-3503
Phone
(760) 775-5552
NPI assigned
Nov 7, 2023
Last updated
Nov 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Authorized official

Name
Elvia Juarez-Mata, DDSNPI 1689710626
Title
Owner
Phone
(760) 775-5552

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

3333 W Ramsey St
Banning, CA 92220-3503

Mailing address

82204 US Highway 111
Indio, CA 92201-5630
Phone (760) 775-5552

Other names 1

  • EJ Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ej Dental6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

3333 W Ramsey St
Banning, CA 92220
Phone (760) 775-5552

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1699315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1467226795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82204 US HIGHWAY 111",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015630",
            "telephone_number": "760-775-5552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W RAMSEY ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922203503",
            "telephone_number": "760-775-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVIA JUAREZ A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-07",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "JUAREZ-MATA",
        "authorized_official_first_name": "ELVIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-775-5552",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EJ Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Banning, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 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.