Active NPI
Elvin Guadiz Tolentino
- Dentist
- San Bernardino, CA
National Provider Identifier
1750164307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS108982
- Practice address
- 159 W Hospitality LN
San Bernardino, CA 92408-3348 - Phone
- (909) 558-4960
- NPI assigned
- Aug 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS108982 | CA | Primary |
| Dentist | 122300000X | 7970 | NE |
Addresses
Primary practice location
159 W Hospitality LN
San Bernardino, CA 92408-3348
Mailing address
2226 Wild Canyon Dr
Colton, CA 92324-9233
Phone (909) 827-0467
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS108982 | CA | MD | Dentist |
| 7970 | NE | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727222400000",
"number": "1750164307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2226 WILD CANYON DR",
"city": "COLTON",
"state": "CA",
"postal_code": "923249233",
"telephone_number": "909-827-0467"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 W HOSPITALITY LN",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924083348",
"telephone_number": "909-558-4960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLENTINO",
"first_name": "ELVIN",
"middle_name": "GUADIZ",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-17",
"last_updated": "2024-09-25",
"certification_date": "2024-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS108982",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NE",
"license": "7970",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.