Family Dentistry at Turner Plaza

Primary specialty

DentistTaxonomy code 122300000X

License

41760 Issued in CA

Legal business name

FAMILY DENTISTRY AT TURNER PLAZA

Practice address

10064 Arrow Rte
Rancho Cucamonga, CA 91730-4194

Phone

(909) 987-5522

Fax

(909) 987-5532

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Krishan K Mittal, DDS

Title

Dentist Owner

Phone

(909) 987-5522

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216166400000",
    "number": "1821212010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10064 ARROW RTE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304194",
            "telephone_number": "909-987-5522",
            "fax_number": "909-987-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10064 ARROW RTE",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917304194",
            "telephone_number": "909-987-5522",
            "fax_number": "909-987-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY AT TURNER PLAZA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2008-07-16",
        "status": "A",
        "authorized_official_last_name": "MITTAL",
        "authorized_official_first_name": "KRISHAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "909-987-5522",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92877",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rommie Fawzi Fakhoury, MD
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• Regina Yvette Famiglietti, MS, LMFT
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• Stacie Lynn Fanelli, LCSW
• John Fang, L.AC.
• Kevin Fang, DMD
• Stephanie Fang

• Dentist in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.