NPIMap

Organization Active NPI

Trevor Thomas Dental Corporation

Doing business as Corona Modern Dentistry Dental Group

  • General Practice Dentistry
  • Corona, CA
National Provider Identifier
1639731888
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
TREVOR THOMAS DENTAL CORPORATION
Doing business as
Corona Modern Dentistry Dental Group
Practice address
460 N McKinley St Ste 101
Corona, CA 92879-3405
Phone
(951) 531-9693
Fax
(951) 905-1704
NPI assigned
Jul 8, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Authorized official

Name
Trevor J Thomas, DDS
Title
Owner
Phone
(951) 531-9693

Specialties & licenses 1

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

Addresses

Primary practice location

460 N McKinley St Ste 101
Corona, CA 92879-3405

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Corona Modern Dentistry Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

460 N McKinley St
Ste 101
Corona, CA 92879
Phone (951) 531-9693

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1562544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562544000000",
    "number": "1639731888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 N MCKINLEY ST STE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928793405",
            "telephone_number": "951-531-9693",
            "fax_number": "951-905-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVOR THOMAS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-08",
        "last_updated": "2019-07-08",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-531-9693",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Corona Modern Dentistry Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2019; 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.