NPIMap

Organization Active NPI

Desar Professional Dental Corporation

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1487792586
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41395 Issued in CA
Legal business name
DESAR PROFESSIONAL DENTAL CORPORATION
Practice address
6700 Indiana Ave Ste 115
Riverside, CA 92506-4297
Phone
(951) 276-2222
Fax
(951) 276-2222
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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

Authorized official

Name
Dr. Jyoti V Desar, DDSNPI 1205983830
Title
Owner
Phone
(951) 276-2222

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 41395 CA Primary

Addresses

Primary practice location

6700 Indiana Ave Ste 115
Riverside, CA 92506-4297

Mailing address

6700 Indiana Ave Ste 115
Riverside, CA 92506-4297
Phone (951) 276-2222

Other names 1

  • Victoria Village Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

6700 Indiana Ave
Ste 115
Riverside, CA 92506
Phone (951) 276-2222

Practitioners & affiliated clinicians

Practitioners 2

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347321600000",
    "number": "1487792586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 INDIANA AVE STE 115",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064297",
            "telephone_number": "951-276-2222",
            "fax_number": "951-276-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 INDIANA AVE STE 115",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925064297",
            "telephone_number": "951-276-2222",
            "fax_number": "951-276-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESAR PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-09-11",
        "status": "A",
        "authorized_official_last_name": "DESAR",
        "authorized_official_first_name": "JYOTI",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-276-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victoria Village Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.