NPIMap

Organization Active NPI

Anthony P Varboncoeur DDC Inc & Cortland S Caldemeyer DDS Apc GP

  • Dentist
  • La Mesa, CA
National Provider Identifier
1710023213
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47693
Legal business name
ANTHONY P VARBONCOEUR DDC INC & CORTLAND S CALDEMEYER DDS APC GP
Practice address
5565 Grossmont Center Dr
BLD 1 Ste 129
La Mesa, CA 91942
Phone
(619) 463-4486
Fax
(619) 463-6553
NPI assigned
Jan 30, 2007
Last updated
Apr 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Dr. Cortland S. Caldemeyer, DDSNPI 1407909724
Title
Partner
Phone
(619) 463-4486

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 47693 Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 37512
Oral and Maxillofacial Pathology DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0106X

Addresses

Primary practice location

5565 Grossmont Center Dr
BLD 1 Ste 129
La Mesa, CA 91942

Mailing address

5565 Grossmont Center Dr
BLD 1 Ste 129
La Mesa, CA 91942
Phone (619) 463-4486

Other names 1

  • P.Thomas Hiser DDS, MS, Inc. - Anthony P. Varboncoeur DDS, Inc. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1710023213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLD 1 STE 129",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-463-4486",
            "fax_number": "619-463-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "BLD 1 STE 129",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "91942",
            "telephone_number": "619-463-4486",
            "fax_number": "619-463-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY P VARBONCOEUR DDC INC & CORTLAND S CALDEMEYER DDS APC GP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "CALDEMEYER",
        "authorized_official_first_name": "CORTLAND",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "619-463-4486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": "47693",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": "37512",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "P.Thomas Hiser DDS, MS, Inc. - Anthony P. Varboncoeur DDS, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.