NPIMap

Organization Active NPI

Llusd Dental Hygiene Program & Clinic

  • Dental Hygienist
  • Palm Desert, CA
National Provider Identifier
1558776906
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
7547 Issued in CA
Legal business name
LLUSD DENTAL HYGIENE PROGRAM & CLINIC
Practice address
34280 Gateway Dr
Palm Desert, CA 92211-0857
Phone
(760) 324-2091
Fax
(760) 324-9509
NPI assigned
Jun 24, 2014
Organization subpart
Yes
Parent organization
LOMA LINDA UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Authorized official

Name
Mr. Rodney Dale Neal
Title
Sr VP Finance
Phone
(909) 558-4543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental HygienistGroup: 193400000X SINGLE SPECIALTY GROUP 124Q00000X 7547 CA Primary

Addresses

Primary practice location

34280 Gateway Dr
Palm Desert, CA 92211-0857

Mailing address

11092 Anderson St
Loma Linda, CA 92350-1706
Phone (909) 558-4613

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda University School of Dentistry20 organizations share this tax ID, including this one
Part of
Loma Linda University School of Dentistry

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

34280 Gateway Dr
Palm Desert, CA 92211
Phone (760) 324-2091

NPI Registry JSON

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403568000000",
    "number": "1558776906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11092 ANDERSON ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501706",
            "telephone_number": "909-558-4613",
            "fax_number": "909-558-4192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34280 GATEWAY DR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922110857",
            "telephone_number": "760-324-2091",
            "fax_number": "760-324-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LLUSD DENTAL HYGIENE PROGRAM & CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LOMA LINDA UNIVERSITY",
        "enumeration_date": "2014-06-24",
        "last_updated": "2014-06-24",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "SR VP FINANCE",
        "authorized_official_telephone_number": "909-558-4543",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "7547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2014; 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.