American Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

35537 Issued in CA

Legal business name

AMERICAN DENTAL GROUP

Practice address

436 N Sunset Ave
West Covina, CA 91790-1652

Phone

(626) 337-7271

Fax

(626) 337-8125

NPI assigned

Jun 6, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Serge A Prescott, DDS

Title

Dentist

Phone

(626) 337-7271

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1497914154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 N SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917901652",
            "telephone_number": "626-337-7271",
            "fax_number": "626-337-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 N SUNSET AVE",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917901652",
            "telephone_number": "626-337-7271",
            "fax_number": "626-337-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "PRESCOTT",
        "authorized_official_first_name": "SERGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "626-337-7271",
        "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": "35537",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "14915",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "25306",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "RDH16115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Jean Amato, PAC
• Rebecca Amavizca, LCSW
• Phattharin Amawasri
• Kimberly Berenice Amaya
• Mohammed Amer, PTA
• American Empire Home Health Care Services, Inc
• American Quality Care Home Incorporation
• American Quality Care, Inc.
• Americans First Medical Equipment & Supplies LLC
• Yuwen Edie Ames, OQP/PP

• General Practice Dentistry in West Covina, CA
• Providers in West Covina, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.