NPIMap

Organization Active NPI

United Dental

  • General Practice Dentistry
  • El Monte, CA
National Provider Identifier
1619187747
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47081 Issued in CA
Legal business name
UNITED DENTAL
Practice address
11912 Valley Blvd
Suite a
El Monte, CA 91732-3153
Phone
(626) 444-5500
Fax
(626) 444-4041
NPI assigned
May 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Maria C Gonzalez, M.D.
Title
Owner
Phone
(626) 444-5500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 47081 CA Primary

Addresses

Primary practice location

11912 Valley Blvd
Suite a
El Monte, CA 91732-3153

Mailing address

11912 Valley Blvd
Suite a
El Monte, CA 91732-3153
Phone (626) 444-5500

Other identifiers 1

IdentifierTypeStateIssuer
G92063-01OtherCADENTI-CAL

National Provider Directory

National Provider Directory
Tax ID family
United Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619187747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11912 VALLEY BLVD",
            "address_2": "SUITE A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323153",
            "telephone_number": "626-444-5500",
            "fax_number": "626-444-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11912 VALLEY BLVD",
            "address_2": "SUITE A",
            "city": "EL MONTE",
            "state": "CA",
            "postal_code": "917323153",
            "telephone_number": "626-444-5500",
            "fax_number": "626-444-4041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-444-5500",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL",
            "identifier": "G92063-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Monte, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.