Lance C. Bautista DDS, Inc.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LANCE C. BAUTISTA DDS, INC.

Practice address

1213 Coffee Rd Ste E
Modesto, CA 95355-4229

Phone

(209) 523-5437

Fax

(209) 523-5436

NPI assigned

Apr 16, 2019

Organization subpart

No

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

Authorized official

Name

Lance C. Bautista, DDS

Title

Ceo, President

Phone

(209) 523-5437

Specialties & licenses 1

Addresses

Other names 1

• Dr. Lance C. Bautista Pediatric Dentistry Other name

Locations

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1730742701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD STE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-523-5437",
            "fax_number": "209-523-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD STE E",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-523-5437",
            "fax_number": "209-523-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANCE C. BAUTISTA DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO, PRESIDENT",
        "authorized_official_telephone_number": "209-523-5437",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Lance C. Bautista Pediatric Dentistry",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erica Lamb
• Matthew James Lambert, FNP
• Carissa Lamore, AU.D.
• Bret Eric Lampman
• Carolyn Robin Lanam, M.D.
• Alondra Landa
• Jesus Landa
• Justin Richard Landa
• Kitzya Landa
• Mayra Landeros Aguilar

• Pediatric Dentistry in Modesto, CA
• Providers in Modesto, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.