Organization Active NPI

Apple Valley Periodontal Associates

  • Periodontics
  • Apple Valley, CA
National Provider Identifier
1609536416
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
APPLE VALLEY PERIODONTAL ASSOCIATES
Practice address
18092 Wika Rd Ste 210
Apple Valley, CA 92307-2132
Phone
(760) 946-2100
NPI assigned
Dec 20, 2021
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
Caitlyn Kendra AffruntiNPI 1316316938
Title
Partner
Phone
(760) 946-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

18092 Wika Rd Ste 210
Apple Valley, CA 92307-2132

Mailing address

10630 Town Center Dr Ste 125
Rancho Cucamonga, CA 91730-6889
Phone (909) 483-3131

National Provider Directory

National Provider Directory

Locations

18092 Wika Rd
Ste 210
Apple Valley, CA 92307
Phone (760) 946-2100

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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": "1609536416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10630 TOWN CENTER DR STE 125",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306889",
            "telephone_number": "909-483-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18092 WIKA RD STE 210",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072132",
            "telephone_number": "760-946-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APPLE VALLEY PERIODONTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-20",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "AFFRUNTI",
        "authorized_official_first_name": "CAITLYN",
        "authorized_official_middle_name": "KENDRA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "760-946-2100"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, 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.