Dr. Rusen Victorville Friendly Smiles Dental Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR. RUSEN VICTORVILLE FRIENDLY SMILES DENTAL INC.

Practice address

15401 Anacapa Rd Ste 3
Victorville, CA 92392-2466

Phone

(213) 324-6000

NPI assigned

Sep 28, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Rares Dan Rusen, DDS

Title

Ceo

Phone

(213) 324-6000

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1518639681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15401 ANACAPA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15401 ANACAPA RD STE 3",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923922466",
            "telephone_number": "213-324-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RUSEN VICTORVILLE FRIENDLY SMILES DENTAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A",
        "authorized_official_last_name": "RUSEN",
        "authorized_official_first_name": "RARES",
        "authorized_official_middle_name": "DAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "213-324-6000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "victorvillefriendlysmiles.com",
            "affiliation": "N",
            "address_1": "15401 Anacapa Rd Ste 3",
            "city": "Victorville",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923922466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.