NPIMap

Organization Active NPI

Pacific Dental Services

  • Dentist
  • Victorville, CA
National Provider Identifier
1912305236
Registry record updated Dec 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63655 Issued in CA
Legal business name
PACIFIC DENTAL SERVICES
Practice address
15667 Roy Rogers Dr
Ste. A101
Victorville, CA 92394-2158
Phone
(760) 843-5824
NPI assigned
Dec 18, 2014
Last updated
Dec 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2014

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

Authorized official

Name
Ritesh Kumar
Title
Owner Doctor
Phone
(760) 843-5824

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63655 CA Primary

Addresses

Primary practice location

15667 Roy Rogers Dr
Ste. A101
Victorville, CA 92394-2158

Mailing address

15667 Roy Rogers Dr
Ste. A101
Victorville, CA 92394-2158

National Provider Directory

National Provider Directory
Tax ID family
Amanda Girardi5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

15667 Roy Rogers Dr
Ste A101
Victorville, CA 92394
Phone (760) 843-5824

Practitioners & affiliated clinicians

Practitioners 5

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": "1418860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418860800000",
    "number": "1912305236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15667 ROY ROGERS DR",
            "address_2": "STE. A101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923942158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15667 ROY ROGERS DR",
            "address_2": "STE. A101",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923942158",
            "telephone_number": "760-843-5824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC DENTAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-18",
        "last_updated": "2014-12-18",
        "status": "A",
        "authorized_official_last_name": "KUMAR",
        "authorized_official_first_name": "RITESH",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "760-843-5824"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2014; 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.