Cristina B Gamboa DDS Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

B43600 Issued in CA

Legal business name

CRISTINA B GAMBOA DDS INC

Practice address

125 E Glenoaks Blvd
102
Glendale, CA 91207

Phone

(818) 247-2611

Fax

(818) 247-4387

NPI assigned

Nov 9, 2007

Organization subpart

No

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

Authorized official

Name

Cristina B Gamboa, DDSNPI 1144282963

Title

President

Phone

(818) 247-2611

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Cristina B Gamboa, D.D.S.

  • General Practice Dentistry
  • Glendale, CA
  • NPI 1144282963
  NPD (past) Authorized official

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

{
    "created_epoch": "1194566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194566400000",
    "number": "1821278508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 E GLEN OAKS BLVD",
            "address_2": "102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91207",
            "telephone_number": "818-247-2611",
            "fax_number": "818-247-4387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 E GLENOAKS BLVD",
            "address_2": "102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91207",
            "telephone_number": "818-247-2611",
            "fax_number": "818-247-4387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISTINA B GAMBOA DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-09",
        "last_updated": "2007-11-09",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "CRISTINA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-247-2611",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "B43600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Glendale, CA
• Providers in Glendale, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2007; 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.