NPIMap

Organization Active NPI

Dmitry Tubis D.D.S., Inc.

  • General Practice Dentistry
  • West Covina, CA
National Provider Identifier
1629193172
Registry record updated Sep 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49691 Issued in CA
Legal business name
DMITRY TUBIS D.D.S., INC.
Practice address
1710 W Cameron Ave
Suite 100
West Covina, CA 91790-2720
Phone
(626) 962-4428
Fax
(626) 962-9789
NPI assigned
Mar 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2015

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

Authorized official

Name
Dr. Dmitry Tubis, DDS
Title
Dentist Owner
Phone
(626) 962-4428

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 49691 CA Primary

Addresses

Primary practice location

1710 W Cameron Ave
Suite 100
West Covina, CA 91790-2720

Mailing address

1710 W Cameron Ave
Suite 100
West Covina, CA 91790-2720
Phone (626) 962-4428

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443398400000",
    "number": "1629193172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W CAMERON AVE",
            "address_2": "SUITE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902720",
            "telephone_number": "626-962-4428",
            "fax_number": "626-962-9789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W CAMERON AVE",
            "address_2": "SUITE 100",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917902720",
            "telephone_number": "626-962-4428",
            "fax_number": "626-962-9789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMITRY TUBIS D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2015-09-28",
        "status": "A",
        "authorized_official_last_name": "TUBIS",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "626-962-4428",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2015; 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.