NPIMap

Organization Active NPI

Cental Dental

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1861750291
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CENTAL DENTAL
Practice address
222 N G St Ste 3
San Bernardino, CA 92410-3217
Phone
(909) 383-7777
Fax
(909) 383-7779
NPI assigned
Apr 23, 2012
Last updated
Apr 23, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
CENTRAL DENTALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Dr. Brian C Kim, DDSNPI 1467521443
Title
Dentist/Owner
Phone
(909) 383-7777

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

222 N G St Ste 3
San Bernardino, CA 92410-3217

Mailing address

222 N G St Ste 3
San Bernardino, CA 92410-3217
Phone (909) 383-7777

National Provider Directory

National Provider Directory
Part of
Cental Dental

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1335139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1861750291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N G ST STE 3",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103217",
            "telephone_number": "909-383-7777",
            "fax_number": "909-383-7779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N G ST STE 3",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924103217",
            "telephone_number": "909-383-7777",
            "fax_number": "909-383-7779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTAL DENTAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CENTRAL DENTAL",
        "enumeration_date": "2012-04-23",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "909-383-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 23, 2012; 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.