NPIMap

Organization Active NPI

Feldkamp Cal Select Dental Group, Inc.

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1669036117
Registry record updated Aug 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FELDKAMP CAL SELECT DENTAL GROUP, INC.
Practice address
164 W Hospitality LN Ste 127
San Bernardino, CA 92408-3316
Phone
(909) 453-6600
NPI assigned
Apr 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2020

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

Authorized official

Name
Dr. Irving Moore Feldkamp III, DDS
Title
Owner
Phone
(909) 453-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

164 W Hospitality LN Ste 127
San Bernardino, CA 92408-3316

Mailing address

164 W. Hospitality Lane
Suite 127
San Bernardino, CA 92408-3329
Phone (909) 723-1088

National Provider Directory

National Provider Directory
Tax ID family
Feldkamp Cal Select Dental Group Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

164 W Hospitality Ln
Ste 127
San Bernardino, CA 92408
Phone (909) 453-6600

Practitioners & affiliated clinicians

Practitioners 5

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": "1556582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1669036117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 W. HOSPITALITY LANE",
            "address_2": "SUITE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083329",
            "telephone_number": "909-723-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083316",
            "telephone_number": "909-453-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELDKAMP CAL SELECT DENTAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-30",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "FELDKAMP III",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-453-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.