Laura Y. Jimenez, DDS Prof. Dental Corp

Primary specialty

DentistTaxonomy code 122300000X

License

55254 Issued in CA

Legal business name

LAURA Y. JIMENEZ, DDS PROF. DENTAL CORP

Practice address

17500 Foothill Blvd
Fontana, CA 92335-3736

Phone

(909) 357-7000

NPI assigned

Sep 15, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Laura Ysolina Jimenez, D.D.S

Title

President

Phone

(909) 350-2598

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1487803433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17500 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353736",
            "telephone_number": "909-357-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17500 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923353736",
            "telephone_number": "909-357-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURA Y. JIMENEZ, DDS PROF. DENTAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "YSOLINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-350-2598",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "55254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Douglas Anthony Lavalley, PT
• Michael A. Lawrence, MD
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• Teri Marie Lay, LVN

• Dentist in Fontana, CA
• Providers in Fontana, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.