Edward J Formica D.D.S., Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EDWARD J FORMICA D.D.S., INC.

Practice address

1303 S State St
Hemet, CA 92543-7624

Phone

(951) 925-6444

Fax

(951) 848-9443

NPI assigned

Apr 11, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Edward J Formica, DDSNPI 1124114897

Title

Ceo/President

Phone

(951) 925-6444

Specialties & licenses 1

Addresses

Other names 1

• Formica Family Dental Practice Edward J Formica DDS, Inc. Doing business as

Locations

Practitioners 1

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

• Edward Joseph Formica, D.D.S.

  • Dentist
  • Hemet, CA
  • NPI 1124114897
  NPD Authorized official

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

{
    "created_epoch": "1712793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720483200000",
    "number": "1619721297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26580 RIO VISTA DR",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925446772",
            "telephone_number": "951-235-1438",
            "fax_number": "951-848-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437624",
            "telephone_number": "951-925-6444",
            "fax_number": "951-848-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARD J FORMICA D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "FORMICA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "951-925-6444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Formica Family Dental Practice Edward J Formica DDS, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Formica Family Dental Practice Edward J Formica DDS, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Johna Eatherton
• Alexis Eberhard
• George Ebert, SUDCC LL #2533
• Marta Yamileth Echegoyen
• Edge Medical Services
• Tanasha Edwards
• Benson Eghreriniovo, MD
• Curtis J Eirew, RPH
• Khaled Eissa, BDS
• Iglal El Henawi, MD

• General Practice Dentistry in Hemet, CA
• Providers in Hemet, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; 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.