Fontana Dental Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

44119 Issued in CA

Legal business name

FONTANA DENTAL CLINIC

Practice address

16989 Valley Blvd
Suite B
Fontana, CA 92335-6806

Phone

(909) 829-3535

Fax

(909) 829-8557

NPI assigned

Feb 25, 2011

Last updated

Feb 25, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jose Alfredo Velazquez, DDS

Title

President

Phone

(909) 829-3535

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298592000000",
    "number": "1639476765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16989 VALLEY BLVD",
            "address_2": "SUITE B",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356806",
            "telephone_number": "909-829-3535",
            "fax_number": "909-829-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16989 VALLEY BLVD",
            "address_2": "SUITE B",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356806",
            "telephone_number": "909-829-3535",
            "fax_number": "909-829-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FONTANA DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2011-02-25",
        "status": "A",
        "authorized_official_last_name": "VELAZQUEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "ALFREDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-829-3535",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth E Fong, PHARM D
• Li Ming Fong
• Shirley Fong, MD
• Fontana Artificial Limb & Brace Inc.
• Fontana Chiropractic and Acupuncture
• Fontana Family Acupuncture Inc.
• Fontana Healthcare, LLC (Casa Maria Healthcare Center)
• Fontana Modern Dentistry, Inc
• Fontana Optometric Group, Inc.
• Fontana Physicians Associates a Medical Corporation (Fontana Clinica Medica Familiar)

• General Practice Dentistry in Fontana, CA
• Providers in Fontana, 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 Feb 25, 2011; 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.