Active NPI
Dr. J L Maddatu Dental Corp.
- Dentist
- Lancaster, CA
National Provider Identifier
1790118222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55562
- Legal business name
- DR. J L MADDATU DENTAL CORP.
- Practice address
- 44841 10TH St W
None
Lancaster, CA 93534-2311 - Phone
- (661) 948-1655
- Fax
- (661) 940-9636
- NPI assigned
- Aug 20, 2013
- Organization subpart
- Yes
- Parent organization
- JONATHAN L. MADDATU DDS INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jonathan Lorenzo Maddatu, DDS
- Title
- Dentist/Owner
- Phone
- (818) 786-8803
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 55562 | CA | Primary |
Addresses
Primary practice location
44841 10TH St W
None
Lancaster, CA 93534-2311
Mailing address
44841 10TH St W
None
Lancaster, CA 93534-2311
Phone (661) 948-1655
Other names 1
- Jonathan L. Maddatu DDS
National Provider Directory
National Provider Directory- Part of
- Jonathan L Maddatu DDS Inc
Locations
44841 10th St W
Lancaster, CA 93534
Phone (661) 948-1655
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- General Practice Dentistry
- Van Nuys, CA
- NPI 1265696173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376956800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1376956800000",
"number": "1790118222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44841 10TH ST W",
"address_2": "NONE",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342311",
"telephone_number": "661-948-1655",
"fax_number": "661-940-9636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44841 10TH ST W",
"address_2": "NONE",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935342311",
"telephone_number": "661-948-1655",
"fax_number": "661-940-9636"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DR. J L MADDATU DENTAL CORP.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "JONATHAN L. MADDATU DDS INC.",
"enumeration_date": "2013-08-20",
"last_updated": "2013-08-20",
"status": "A",
"authorized_official_last_name": "MADDATU",
"authorized_official_first_name": "JONATHAN",
"authorized_official_middle_name": "LORENZO",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "818-786-8803",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "CA",
"license": "55562",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Jonathan L. Maddatu DDS",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.