NPIMap

Organization Active NPI

Jose M Duenes a Professional Dental Corp Dba Mira Costa Dental

Doing business as Mira Costa Dental

  • Dentist
  • Oceanside, CA
National Provider Identifier
1760682686
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35047 Issued in CA
Legal business name
JOSE M DUENES A PROFESSIONAL DENTAL CORP DBA MIRA COSTA DENTAL
Doing business as
Mira Costa Dental
Practice address
3502 College Blvd
Ste B
Oceanside, CA 92056
Phone
(760) 941-7502
Fax
(760) 940-2704
NPI assigned
Jul 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2008

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

Authorized official

Name
Mr. Jose M Duenes, DDSNPI 1922140391
Title
Owner President
Phone
(760) 941-7502

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 35047 CA Primary

Addresses

Primary practice location

3502 College Blvd
Ste B
Oceanside, CA 92056

Mailing address

3502 College Blvd
Ste B
Oceanside, CA 92056
Phone (760) 941-7502

Other names 1

  • Mira Costa Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3502 College Blvd
Ste B
Oceanside, CA 92056
Phone (760) 941-7502

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1760682686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 COLLEGE BLVD",
            "address_2": "STE B",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92056",
            "telephone_number": "760-941-7502",
            "fax_number": "760-940-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 COLLEGE BLVD",
            "address_2": "STE B",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92056",
            "telephone_number": "760-941-7502",
            "fax_number": "760-940-2704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSE M DUENES A PROFESSIONAL DENTAL CORP DBA MIRA COSTA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-19",
        "last_updated": "2008-07-17",
        "status": "A",
        "authorized_official_last_name": "DUENES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "760-941-7502",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "35047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mira Costa Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.