Medical Dental Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY44342 Issued in CA

Legal business name

MEDICAL DENTAL PHARMACY

Practice address

689 E Nees Ave
Fresno, CA 93720-2106

Phone

(559) 439-1190

Fax

(559) 439-1165

NPI assigned

Aug 18, 2006

Organization subpart

No

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

Authorized official

Name

Diana Smith, PHARMD

Title

Ceo

Phone

(559) 439-1190

Specialties & licenses 4

Addresses

Other identifiers 2

Other names 1

• MEDICAL DENTAL PHARMACY Doing business as

Locations

Practitioners 2

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

• Diana Lynn Smith Laurent, PHARMD

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Fresno, CA
  • NPI 1518288224
  NPD (past)
• Lusha Yu, RPH

  • Pharmacist
  • Antioch, CA
  • NPI 1578994091
  NPD (past)

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1609980671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "689 E NEES AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202106",
            "telephone_number": "559-439-1190",
            "fax_number": "559-439-1165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "689 E NEES AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937202106",
            "telephone_number": "559-439-1190",
            "fax_number": "559-439-1165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL DENTAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "559-439-1190",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "CA",
            "license": "PHY44342",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2000624",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PHA44342",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDICAL DENTAL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Medeiros MD PC
• Kari Anne Medeiros, AMFT
• Rosario Medel
• Kacey Alexandra Medellin, LMFT
• Medentrix Care LLC
• Medical Groups of Downtown Fresno
• Medical Support Los Angeles a Medical Corporation
• Medilogistics LLC
• Abril Medina Arriaga
• Diana Lizbeth Medina Carrillo

• Community/Retail Pharmacy in Fresno, CA
• Providers in Fresno, CA by specialty
• Community/Retail Pharmacy in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.