Fred T. Powers Jr., DMD, Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

33356 Issued in CA

Legal business name

FRED T. POWERS JR., DMD, INC

Practice address

27701 Scott Rd
D-107
Menifee, CA 92584-9417

Phone

(951) 301-6100

NPI assigned

Jul 16, 2015

Organization subpart

No

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

Authorized official

Name

Dawn R Powers

Title

Owner/Office Manager

Phone

(951) 301-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Powers Dentistry Doing business as

Locations

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437004800000",
    "number": "1497139703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27701 SCOTT RD",
            "address_2": "D-107",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849417",
            "telephone_number": "951-301-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27701 SCOTT RD",
            "address_2": "D-107",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849417",
            "telephone_number": "951-301-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED T. POWERS JR., DMD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-07-16",
        "status": "A",
        "authorized_official_last_name": "POWERS",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/OFFICE MANAGER",
        "authorized_official_telephone_number": "951-301-6100"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "33356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEACTIVATED NPI DUE TO DEATH OF HEALTH CARE PROVIDER",
            "identifier": "1013058551",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powers Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Preferred Provider Organization in Menifee, CA
• Providers in Menifee, CA by specialty
• Preferred Provider Organization in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2015; 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.