MC Cormack Dental Xray Inc.

Primary specialty

Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X

License

RHP00040925 Issued in CA

Legal business name

MC CORMACK DENTAL XRAY INC.

Practice address

395 N. Second Ave.
Upland, CA 91786

Phone

(909) 985-3030

Fax

(909) 946-1200

NPI assigned

Apr 19, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Valerie J Wells, LICENSED CALIFORNIA

Title

President/X-Ray Tech

Phone

(909) 921-4273

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1492560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492560000000",
    "number": "1558895243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "395 N. SECOND AVE.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-3030",
            "fax_number": "909-946-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 N. SECOND AVE.",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-3030",
            "fax_number": "909-946-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC CORMACK DENTAL XRAY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-19",
        "last_updated": "2017-04-19",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT/X-RAY TECH",
        "authorized_official_telephone_number": "909-921-4273",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LICENSED CALIFORNIA"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "CA",
            "license": "RHP00040925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Max V. Soliguen, M.D., Inc. Dba Kids First Pediatrics
• Corinne Erica Maxwell, PA-C
• Mayberry Care, Inc.
• Saniyyah Shaleece Mayo
• Mayra Munguia, DDS, Inc
• Lauren Marie McCarroll
• Stuart A McCarthy, M.D.
• Joseph Charles McCarty Jr., PH.D., NCSP
• Rossana McClean
• Heather McCone

• Radiologic Technologist in Upland, CA
• Providers in Upland, CA by specialty
• Radiologic Technologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2017; 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.