Individual provider Active NPI

Michael John Belton, DDS, MD INC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Rancho Cucamonga, CA
National Provider Identifier
1720174832
Registry record updated Jun 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
A90801 Issued in CA
Practice address
10470 Foothill Blvd
Suite 122
Rancho Cucamonga, CA 91730-3754
Phone
(909) 989-2303
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52203 CA
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X A90801 CA Primary

Addresses

Primary practice location

10470 Foothill Blvd
Suite 122
Rancho Cucamonga, CA 91730-3754

Mailing address

9471 Jack Rabbit Dr
Unit 103
Rancho Cucamonga, CA 91730-2776
Phone (909) 483-6864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A90801CAMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467072000000",
    "number": "1720174832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9471 JACK RABBIT DR",
            "address_2": "UNIT 103",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917302776",
            "telephone_number": "909-483-6864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10470 FOOTHILL BLVD",
            "address_2": "SUITE 122",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303754",
            "telephone_number": "909-989-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELTON",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "credential": "DDS, MD INC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52203",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A90801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 28, 2016; 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.