NPIMap

Organization Active NPI

Loma Linda University

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Bernardino, CA
National Provider Identifier
1780740704
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
2007 Issued in CA
Legal business name
LOMA LINDA UNIVERSITY
Practice address
159 W Hospitality LN Ste 201
San Bernardino, CA 92408-3348
Phone
(909) 558-4616
Fax
(909) 651-3096
NPI assigned
Dec 28, 2006
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Rodney D Neal
Title
Vice Chancellor--Loma Linda Univ.
Phone
(909) 558-4543

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 2007 CA Primary

Addresses

Primary practice location

159 W Hospitality LN Ste 201
San Bernardino, CA 92408-3348

Mailing address

159 W Hospitality LN Ste 201
San Bernardino, CA 92408-3348
Phone (909) 558-4616

Other identifiers 1

IdentifierTypeStateIssuer
G02000-02MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL dentistry@llu.edu Health Information Exchange (HIE) Loma Linda University

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda University School of Dentistry20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

Organizations that report the same tax identification number in the National Provider Directory.

View all 19

Locations

159 W Hospitality Ln
Ste 201
San Bernardino, CA 92408
Phone (909) 558-4616

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1780740704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "159 W HOSPITALITY LN STE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083348",
            "telephone_number": "909-558-4616",
            "fax_number": "909-651-3093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 W HOSPITALITY LN STE 201",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083348",
            "telephone_number": "909-558-4616",
            "fax_number": "909-651-3096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE CHANCELLOR--LOMA LINDA UNIV.",
        "authorized_official_telephone_number": "909-558-4543"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "2007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G02000-02",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "dentistry@llu.edu",
            "affiliation": "Y",
            "affiliationName": "Loma Linda University",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "159 W Hospitality Ln Ste 201",
            "city": "San Bernardino",
            "state": "CA",
            "country_code": "US",
            "postal_code": "924083348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 27, 2023; 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.