Sofia J Baltazar DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

49466 Issued in CA

Legal business name

SOFIA J BALTAZAR DDS INC

Practice address

24264 San Fernando Rd
Newhall, CA 91321-2911

Phone

(661) 290-2825

Fax

(661) 290-2864

NPI assigned

Nov 9, 2006

Organization subpart

No

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

Authorized official

Name

Sofia J Baltazar, DDS

Title

President

Phone

(661) 290-2825

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• TL Dental Scaler Co Doing business as

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871663674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24264 SAN FERNANDO RD",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212911",
            "telephone_number": "661-290-2825",
            "fax_number": "661-290-2864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24264 SAN FERNANDO RD",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913212911",
            "telephone_number": "661-290-2825",
            "fax_number": "661-290-2864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOFIA J BALTAZAR DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BALTAZAR",
        "authorized_official_first_name": "SOFIA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "661-290-2825",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "49466",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA",
            "identifier": "B4946601",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "G9255701",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TL Dental Scaler Co",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Newhall, CA
• Providers in Newhall, CA by specialty
• Dentist in California

• 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.