Allegiance Dental Inc

Primary specialty

DentistTaxonomy code 122300000X

License

32622 Issued in CA

Legal business name

ALLEGIANCE DENTAL INC

Practice address

4690 Genesee Ave
Suite B
San Diego, CA 92117-3000

Phone

(858) 279-6100

Fax

(858) 279-6112

NPI assigned

Aug 9, 2011

Organization subpart

No

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

Authorized official

Name

Stuart T Tani, DDS

Title

Owner

Phone

(858) 279-6100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1312848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340928000000",
    "number": "1740569631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4690 GENESEE AVE",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173000",
            "telephone_number": "858-279-6100",
            "fax_number": "858-279-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4690 GENESEE AVE",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173000",
            "telephone_number": "858-279-6100",
            "fax_number": "858-279-6112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEGIANCE DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-09",
        "last_updated": "2012-06-29",
        "status": "A",
        "authorized_official_last_name": "TANI",
        "authorized_official_first_name": "STUART",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-279-6100",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "32622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Dewayne Allard, IDC
• Jaclyn Judith Allavie-Davis, NP
• Lauren Allbee, ACSW
• Emily Allbritain
• Rachel C Allchin, SLP
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• Allen Chung OD Optometric Corporation
• Allen Job, DDS, Ms, MPH, Inc.
• Claudette Allen-Butler, LAADC
• Brenda Lee Allen-Crain, B.S,C.A.T.C

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2012; 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.