NPIMap

Organization Active NPI

Soboh Dental Incorporated

  • Dental Clinic/Center
  • Pomona, CA
National Provider Identifier
1922291129
Registry record updated Aug 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
49415 Issued in CA
Legal business name
SOBOH DENTAL INCORPORATED
Practice address
101 W Mission Blvd
Suite 221
Pomona, CA 91766-1711
Phone
(909) 622-6633
Fax
(909) 622-6630
NPI assigned
Aug 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2007

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

Authorized official

Name
Dr. Ahmed Soboh, D.D.S.NPI 1689706012
Title
Owner
Phone
(909) 622-6633

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
Dental Clinic/Center 261QD0000X 49415 CA Primary

Addresses

Primary practice location

101 W Mission Blvd
Suite 221
Pomona, CA 91766-1711

Mailing address

101 W Mission Blvd
Suite 221
Pomona, CA 91766-1711
Phone (909) 622-6633

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1922291129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MISSION BLVD",
            "address_2": "SUITE 221",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661711",
            "telephone_number": "909-622-6633",
            "fax_number": "909-622-6630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W MISSION BLVD",
            "address_2": "SUITE 221",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917661711",
            "telephone_number": "909-622-6633",
            "fax_number": "909-622-6630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBOH DENTAL INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "SOBOH",
        "authorized_official_first_name": "AHMED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "909-622-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "49415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; 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.