NPIMap

Organization Active NPI

Lerian Dental Corporation

Doing business as Gentle Dental Hillsdale

  • General Practice Dentistry
  • San Mateo, CA
National Provider Identifier
1467417378
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13847 Issued in CA
Legal business name
LERIAN DENTAL CORPORATION
Doing business as
Gentle Dental Hillsdale
Practice address
360 Hillsdale Mall
San Mateo, CA 94403-3425
Phone
(650) 341-8008
Fax
(650) 341-7675
NPI assigned
Apr 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Faith Ramientos Tabujara
Title
Credentialing Coordinator
Phone
(209) 476-4728

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 13847 CA Primary

Addresses

Primary practice location

360 Hillsdale Mall
San Mateo, CA 94403-3425

Mailing address

555 W Benjamin Holt Dr
BLDG B
Stockton, CA 95207-3839
Phone (209) 476-4700

Other names 1

  • Gentle Dental Hillsdale Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Gentle Dental Daly City4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1467417378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W BENJAMIN HOLT DR",
            "address_2": "BLDG B",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952073839",
            "telephone_number": "209-476-4700",
            "fax_number": "209-478-8758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HILLSDALE MALL",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944033425",
            "telephone_number": "650-341-8008",
            "fax_number": "650-341-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LERIAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TABUJARA",
        "authorized_official_first_name": "FAITH",
        "authorized_official_middle_name": "RAMIENTOS",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "209-476-4728",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "13847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gentle Dental Hillsdale",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.