Ep Poblete Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

47993 Issued in CA

Legal business name

EP POBLETE DENTAL CORPORATION

Practice address

1915 W Burbank Blvd
Burbank, CA 91506-1316

Phone

(818) 395-1026

NPI assigned

Sep 7, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Editha Pascual Poblete

Title

Dentist

Phone

(818) 395-1026

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1588945307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061316",
            "telephone_number": "818-395-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 W BURBANK BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915061316",
            "telephone_number": "818-395-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EP POBLETE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-07",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "POBLETE",
        "authorized_official_first_name": "EDITHA",
        "authorized_official_middle_name": "PASCUAL",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-395-1026",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "47993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Burbank, CA
• Providers in Burbank, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.