NPIMap

Organization Active NPI

Elvia Juarez a Dental Corporation

  • General Practice Dentistry
  • Lake Elsinore, CA
National Provider Identifier
1871926501
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
ELVIA JUAREZ A DENTAL CORPORATION
Practice address
31500 Grape St Ste 8
Lake Elsinore, CA 92532-9702
Phone
(951) 302-1376
NPI assigned
Aug 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

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

Authorized official

Name
Elvia Juarez-Mata, D.D.SNPI 1689710626
Title
President
Phone
(951) 302-1376

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

31500 Grape St Ste 8
Lake Elsinore, CA 92532-9702

Mailing address

82204 US Highway 111
Suite a
Indio, CA 92201-5630
Phone (760) 775-5552

Other names 1

  • EJ Dental & Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ej Dental6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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": "1376611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629158400000",
    "number": "1871926501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82204 US HIGHWAY 111",
            "address_2": "SUITE A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015630",
            "telephone_number": "760-775-5552",
            "fax_number": "760-841-1982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31500 GRAPE ST STE 8",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925329702",
            "telephone_number": "951-302-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELVIA JUAREZ A DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-16",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "JUAREZ-MATA",
        "authorized_official_first_name": "ELVIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-302-1376",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EJ Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EJ Dental & Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.