Prestige Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRESTIGE DENTAL CORPORATION

Doing business as

SouthBay Dental Center II

Practice address

3535 Callan Blvd Ste a
South San Francisco, CA 94080-5118

Phone

(650) 623-5088

NPI assigned

Oct 30, 2019

Last updated

Oct 30, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Q Viray, DDS

Title

Owner

Phone

(408) 453-9800

Specialties & licenses 1

Addresses

Other names 1

• SouthBay Dental Center II Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christian Norman Dav Yuzon Santa Maria, DDS, PHD

  • General Practice Dentistry
  • Rocklin, CA
  • NPI 1437703352
  NPD

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

{
    "created_epoch": "1572393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572393600000",
    "number": "1679117956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 HOSTETTER RD STE 60",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951313312",
            "telephone_number": "408-453-9800",
            "fax_number": "408-453-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 CALLAN BLVD STE A",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805118",
            "telephone_number": "650-623-5088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-30",
        "last_updated": "2019-10-30",
        "status": "A",
        "authorized_official_last_name": "VIRAY",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "Q",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-453-9800",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SouthBay Dental Center II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SouthBay Dental Center II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Dentist in California

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