NPIMap

Organization Active NPI

Villamor R. Usita, D.D.S., Inc.

  • General Practice Dentistry
  • Rancho Cucamonga, CA
National Provider Identifier
1679620439
Registry record updated Aug 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43504 Issued in CA
Legal business name
VILLAMOR R. USITA, D.D.S., INC.
Practice address
11010 Foothill Blvd
Ste. 120
Rancho Cucamonga, CA 91730-7616
Phone
(909) 481-8881
Fax
(909) 481-7722
NPI assigned
Jan 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2007

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

Authorized official

Name
Dr. Villamor Rialubin Usita, D.D.S.NPI 1366417859
Title
President Dentist
Phone
(909) 481-8881

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 43504 CA Primary

Addresses

Primary practice location

11010 Foothill Blvd
Ste. 120
Rancho Cucamonga, CA 91730-7616

Mailing address

11010 Foothill Blvd
Ste. 120
Rancho Cucamonga, CA 91730-7616
Phone (909) 481-8881

Other identifiers 2

IdentifierTypeStateIssuer
1319695OtherCAUNITED CONCORDIA PROVIDER
B43504-01OtherCADENTI-CAL PROVIDER NUMBER

Other names 1

  • New Smile Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

11010 Foothill Blvd
Ste 120
Rancho Cucamonga, CA 91730
Phone (909) 481-8881

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": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1679620439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11010 FOOTHILL BLVD",
            "address_2": "STE. 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307616",
            "telephone_number": "909-481-8881",
            "fax_number": "909-481-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 FOOTHILL BLVD",
            "address_2": "STE. 120",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307616",
            "telephone_number": "909-481-8881",
            "fax_number": "909-481-7722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAMOR R. USITA, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "USITA",
        "authorized_official_first_name": "VILLAMOR",
        "authorized_official_middle_name": "RIALUBIN",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "909-481-8881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "1319695",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI-CAL PROVIDER NUMBER",
            "identifier": "B43504-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Smile Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rancho Cucamonga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.