Annette Bak Moranda DDS, a Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

48701 Issued in CA

Legal business name

ANNETTE BAK MORANDA DDS, A DENTAL CORPORATION

Practice address

40055 Bob Hope Dr
Suite G
Rancho Mirage, CA 92270-3937

Phone

(760) 321-8003

Fax

(760) 321-9584

NPI assigned

Feb 14, 2008

Last updated

Dec 30, 2009By 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

Dr. Annette Bak Moranda, DDS

Title

Owner

Phone

(760) 321-8003

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1679741367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40055 BOB HOPE DR",
            "address_2": "SUITE G",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703937",
            "telephone_number": "760-321-8003",
            "fax_number": "760-321-9584"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40055 BOB HOPE DR",
            "address_2": "SUITE G",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703937",
            "telephone_number": "760-321-8003",
            "fax_number": "760-321-9584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNETTE BAK MORANDA DDS, A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "MORANDA",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_middle_name": "BAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-321-8003",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Rancho Mirage, CA
• Providers in Rancho Mirage, 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 Dec 30, 2009; 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.