NPIMap

Organization Active NPI

Dewenter Dental Corporation

  • Dentist
  • Cathedral City, CA
National Provider Identifier
1891490926
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
DEWENTER DENTAL CORPORATION
Practice address
67760 E Palm Canyon Dr
Cathedral City, CA 92234-5472
Phone
(760) 688-7653
Fax
(760) 688-7417
NPI assigned
Mar 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Authorized official

Name
Alyssa Dewenter, DDSNPI 1164900031
Title
Owner
Phone
(760) 688-7653

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 Primary

Addresses

Primary practice location

67760 E Palm Canyon Dr
Cathedral City, CA 92234-5472

Mailing address

PO Box 920050
Dallas, TX 75392-0050

Other names 1

  • PALM CANYON SMILES DENTISTRY Doing business as

National Provider Directory

National Provider Directory

Locations

67760 E Palm Canyon Dr
Cathedral City, CA 92234
Phone (760) 688-7653

Practitioners & affiliated clinicians

Practitioners 2

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": "1680134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682035200000",
    "number": "1891490926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67760 E PALM CANYON DR",
            "city": "CATHEDRAL CITY",
            "state": "CA",
            "postal_code": "922345472",
            "telephone_number": "760-688-7653",
            "fax_number": "760-688-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEWENTER DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-30",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A",
        "authorized_official_last_name": "DEWENTER",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "760-688-7653",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PALM CANYON SMILES DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cathedral City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2023; 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.