Allie Nicole Long, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34112 Issued in TX

Practice address

890 Eastlake Parkway
Suite 201
Chula Vista, CA 91914

Phone

(619) 421-2828

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Allie Nicole Long Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• SCDP Eastlake, LLC

  dba Macatangay Dentistry

  • General Practice Dentistry
  • Chula Vista, CA
  • NPI 1407430630
  NPD
• Silver Creek Dental Partners

  dba Eastlake Family Dentistry

  • Dental Clinic/Center
  • Chula Vista, CA
  • NPI 1194572198
  NPD

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713484800000",
    "number": "1659864023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PARKWAY",
            "address_2": "SUITE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91914",
            "telephone_number": "619-421-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 EASTLAKE PARKWAY",
            "address_2": "SUITE 201",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "91914",
            "telephone_number": "619-421-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "ALLIE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2024-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "34112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIE",
            "last_name": "LONG",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Armando Lomeli
• Dominic Dalaten Lomibao, FNP-C
• Andrea Salas Lona
• Anne Magdalena Londo, RPH
• Cristinn Lynnae London
• Chyenne Marie Long
• Lamont Long
• Ryan M Long, DPT
• Angelina Longobardi
• James Joseph Longobardi, DPM

• General Practice Dentistry in Chula Vista, CA
• Providers in Chula Vista, 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 Apr 19, 2024; 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.