Aloha Dental Practice

Primary specialty

DentistTaxonomy code 122300000X

License

039983 Issued in CA

Legal business name

ALOHA DENTAL PRACTICE

Doing business as

Dr Lucky Lucero A Professional Dental Corporation

Practice address

1799 N Waterman Ave
Suite D
San Bernardino, CA 92404

Phone

(909) 882-3745

NPI assigned

Oct 25, 2006

Last updated

Apr 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lucky Lucero, DDS

Title

Ceo

Phone

(909) 882-3745

Specialties & licenses 1

Addresses

Other names 1

• Dr Lucky Lucero A Professional Dental Corporation Doing business as

Locations

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207094400000",
    "number": "1750465431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1799 N WATERMAN AVE",
            "address_2": "SUITE D",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-882-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1799 N WATERMAN AVE",
            "address_2": "SUITE D",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "92404",
            "telephone_number": "909-882-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALOHA DENTAL PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-04-02",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "LUCKY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-882-3745",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "039983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr Lucky Lucero A Professional Dental Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2008; 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.