NPIMap

Organization Active NPI

Image Dental Group

  • Dentist
  • La Mesa, CA
National Provider Identifier
1659545374
Registry record updated Aug 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
51847 Issued in CA
Legal business name
IMAGE DENTAL GROUP
Practice address
7557 El Cajon Blvd
Suite a
La Mesa, CA 91942-7823
Phone
(619) 469-4144
Fax
(619) 469-4143
NPI assigned
Apr 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2012

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

Authorized official

Name
Dr. Prashant Raman Patel, DDS
Title
Owner
Phone
(619) 469-4144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 51847 CA Primary

Addresses

Primary practice location

7557 El Cajon Blvd
Suite a
La Mesa, CA 91942-7823

Mailing address

7557 El Cajon Blvd
Suite a
La Mesa, CA 91942-7823
Phone (619) 469-4144

National Provider Directory

National Provider Directory

Locations

7557 El Cajon Blvd
Ste A
La Mesa, CA 91942
Phone (619) 469-4144

Practitioners & affiliated clinicians

Practitioners 1

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": "1208131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346284800000",
    "number": "1659545374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7557 EL CAJON BLVD",
            "address_2": "SUITE A",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427823",
            "telephone_number": "619-469-4144",
            "fax_number": "619-469-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7557 EL CAJON BLVD",
            "address_2": "SUITE A",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919427823",
            "telephone_number": "619-469-4144",
            "fax_number": "619-469-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-14",
        "last_updated": "2012-08-30",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "PRASHANT",
        "authorized_official_middle_name": "RAMAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-469-4144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "51847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.