NPIMap

Organization Active NPI

Clinica Dental Familiar San Judas Tadeo

  • General Practice Dentistry
  • Ontario, CA
National Provider Identifier
1801029681
Registry record updated Aug 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50895 Issued in CA
Legal business name
CLINICA DENTAL FAMILIAR SAN JUDAS TADEO
Practice address
1245 N Grove Ave Ste C
Ontario, CA 91764-2557
Phone
(909) 458-1068
Fax
(909) 988-0792
NPI assigned
Aug 27, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2009

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

Authorized official

Name
Elizabeth Duarte
Title
Biller
Phone
(909) 988-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 50895 CA Primary

Addresses

Primary practice location

1245 N Grove Ave Ste C
Ontario, CA 91764-2557

Mailing address

1245 N Grove Ave Ste C
Ontario, CA 91764-2557
Phone (909) 458-1068

Other names 1

  • LOURDES CARDOSO DDS INC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clinica Dental Familiar Ontario5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1245 N Grove Ave
Ste C
Ontario, CA 91764
Phone (909) 458-1068

NPI Registry JSON

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

{
    "created_epoch": "1251331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251331200000",
    "number": "1801029681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 N GROVE AVE STE C",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642557",
            "telephone_number": "909-458-1068",
            "fax_number": "909-988-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 N GROVE AVE STE C",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642557",
            "telephone_number": "909-458-1068",
            "fax_number": "909-988-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICA DENTAL FAMILIAR SAN JUDAS TADEO",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-27",
        "last_updated": "2009-08-27",
        "status": "A",
        "authorized_official_last_name": "DUARTE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "909-988-1800"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LOURDES CARDOSO DDS INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2009; 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.