Community Dental Group

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

41396 Issued in CA

Legal business name

COMMUNITY DENTAL GROUP

Practice address

587 N Ventu Park Rd Ste C
Newbury Park, CA 91320-2743

Phone

(805) 499-1253

Fax

(805) 499-1453

NPI assigned

Jan 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Steven Destler, DDS

Title

Dentist/Owner

Phone

(805) 499-1253

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1821487075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "587 N VENTU PARK RD STE C",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913202743",
            "telephone_number": "805-499-1253",
            "fax_number": "805-499-1453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 N VENTU PARK RD STE C",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913202743",
            "telephone_number": "805-499-1253",
            "fax_number": "805-499-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "DESTLER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "805-499-1253",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "41396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Newbury Park, CA
• Providers in Newbury Park, CA by specialty
• Dental Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; 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.