Organization Active NPI

Sam Danieldason DDS Apdc

Doing business as San Bernardino Dental group

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1831226695
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41386 Issued in CA
Legal business name
SAM DANIELDASON DDS APDC
Doing business as
San Bernardino Dental group
Practice address
575 W 5TH St
San Bernardino, CA 92401-1301
Phone
(909) 884-6125
Fax
(909) 885-7556
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Sam Daniel Dason, D.D.SNPI 1871658955
Title
President
Phone
(909) 884-6125

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 41386 CA Primary

Addresses

Primary practice location

575 W 5TH St
San Bernardino, CA 92401-1301

Mailing address

575 W 5TH St
San Bernardino, CA 92401-1301
Phone (909) 884-6125

Other names 1

  • San Bernardino Dental group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sam Daniel Dason DDS Apdc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

575 W 5th St
San Bernardino, CA 92401
Phone (909) 884-6125

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1831226695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 W 5TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011301",
            "telephone_number": "909-884-6125",
            "fax_number": "909-885-7556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 W 5TH ST",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011301",
            "telephone_number": "909-884-6125",
            "fax_number": "909-885-7556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM DANIELDASON DDS APDC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DASON",
        "authorized_official_first_name": "SAM",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-884-6125",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "41386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Bernardino Dental group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.