Organization Active NPI

G & M Dental Corporation

Doing business as Village Dental Care

  • Dentist
  • Upland, CA
National Provider Identifier
1578223582
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
G & M DENTAL CORPORATION
Doing business as
Village Dental Care
Practice address
1227 W Foothill Blvd
Upland, CA 91786-3681
Phone
(909) 608-0700
Fax
(909) 608-0704
NPI assigned
Dec 20, 2021
Last updated
Dec 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Authorized official

Name
Mrs. Roselyn Manalo
Title
Credentialing Coordinator
Phone
(714) 941-9328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

1227 W Foothill Blvd
Upland, CA 91786-3681

Mailing address

1227 W Foothill Blvd
Upland, CA 91786-3681
Phone (909) 608-0700

Other names 1

  • Village Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

1227 W Foothill Blvd
Upland, CA 91786
Phone (909) 608-0700

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1639958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1578223582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863681",
            "telephone_number": "909-608-0700",
            "fax_number": "909-608-0704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 W FOOTHILL BLVD",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917863681",
            "telephone_number": "909-608-0700",
            "fax_number": "909-608-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G & M DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "MANALO",
        "authorized_official_first_name": "ROSELYN",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "714-941-9328",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 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.