NPIMap

Organization Active NPI

Corene J. Poelman, D.D.S., M.S., Apc

  • Endodontics
  • San Diego, CA
National Provider Identifier
1487769121
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
44355 Issued in CA
Legal business name
CORENE J. POELMAN, D.D.S., M.S., APC
Practice address
16466 Bernardo Center Dr
Suite 176
San Diego, CA 92128-2508
Phone
(858) 676-6709
Fax
(858) 676-6739
NPI assigned
Aug 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Corene Janna Poelman, D.D.S., M.S.NPI 1598923674
Title
Owner/Endodontist
Phone
(858) 676-6709

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
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 44355 CA Primary

Addresses

Primary practice location

16466 Bernardo Center Dr
Suite 176
San Diego, CA 92128-2508

Mailing address

16466 Bernardo Center Dr
Suite 176
San Diego, CA 92128-2508
Phone (858) 676-6709

Other names 1

  • Rancho Bernardo Endodontics Doing business as

National Provider Directory

National Provider Directory

Locations

16466 Bernardo Center Dr
Ste 176
San Diego, CA 92128
Phone (858) 676-6709

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1487769121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16466 BERNARDO CENTER DR",
            "address_2": "SUITE 176",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282508",
            "telephone_number": "858-676-6709",
            "fax_number": "858-676-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16466 BERNARDO CENTER DR",
            "address_2": "SUITE 176",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282508",
            "telephone_number": "858-676-6709",
            "fax_number": "858-676-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORENE J. POELMAN, D.D.S., M.S., APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "POELMAN",
        "authorized_official_first_name": "CORENE",
        "authorized_official_middle_name": "JANNA",
        "authorized_official_title_or_position": "OWNER/ENDODONTIST",
        "authorized_official_telephone_number": "858-676-6709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "44355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rancho Bernardo Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.