Tibbitts Fallbrook Dental Group

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TIBBITTS FALLBROOK DENTAL GROUP

Doing business as

Tibbitts Fallbrook Dental Group

Practice address

521 E Elder St Ste 203
Fallbrook, CA 92028-3083

Phone

(760) 728-1592

NPI assigned

Jan 31, 2019

Organization subpart

No

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

Authorized official

Name

Valerie Rogers

Title

Office Manager

Phone

(951) 677-5113

Specialties & licenses 1

Addresses

Other names 1

• Tibbitts Fallbrook Dental Group Doing business as

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

{
    "created_epoch": "1548892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678406400000",
    "number": "1649735986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST STE 203",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283083",
            "telephone_number": "760-728-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E ELDER ST STE 203",
            "city": "FALLBROOK",
            "state": "CA",
            "postal_code": "920283083",
            "telephone_number": "760-728-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIBBITTS FALLBROOK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-31",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "VALERIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "951-677-5113"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tibbitts Fallbrook Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tibbitts Fallbrook Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derek Thomas, LCSW
• Marion Thomas, D.D.S
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• Lacey Erin Troth, ATC

• Dental Clinic/Center in Fallbrook, CA
• Providers in Fallbrook, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; 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.