Individual provider Active NPI

Grace Tolentino Sanchez, D.D.S.

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1598964736
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46131 Issued in CA
Practice address
362 East Vanderbilt Way
San Bernardino, CA 92408
Phone
(909) 384-1111
Fax
(909) 381-2981
NPI assigned
Jul 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 46131 CA Primary

Addresses

Primary practice location

362 East Vanderbilt Way
San Bernardino, CA 92408

Mailing address

362 East Vanderbilt Way
San Bernardino, CA 92408
Phone (909) 384-1111

Other identifiers 1

IdentifierTypeStateIssuer
D46131OtherCADENTI-CAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170220001105 CA Order and Referring Only - DentistPractitioner - Dentist 5991088833

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1184630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1598964736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 EAST VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-384-1111",
            "fax_number": "909-381-2981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 EAST VANDERBILT WAY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92408",
            "telephone_number": "909-384-1111",
            "fax_number": "909-381-2981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANCHEZ",
        "first_name": "GRACE",
        "middle_name": "TOLENTINO",
        "name_prefix": "Mrs.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-17",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "D46131",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.