Organization Active NPI

Inland Empire Dental Specialty Group

  • Endodontics
  • Redlands, CA
National Provider Identifier
1922433531
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
50740 Issued in CA
Legal business name
INLAND EMPIRE DENTAL SPECIALTY GROUP
Practice address
415 Brookside Ave
Redlands, CA 92373-4609
Phone
(909) 792-8440
Fax
(909) 792-9694
NPI assigned
Sep 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Dr. Peter Cho, DDS
Title
Co Owner
Phone
(909) 792-8440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 50740 CA Primary

Addresses

Primary practice location

415 Brookside Ave
Redlands, CA 92373-4609

Mailing address

415 Brookside Ave
Redlands, CA 92373-4609
Phone (909) 792-8440

National Provider Directory

National Provider Directory
Tax ID family
Inland Empire Dental Specialty Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

415 Brookside Ave
Redlands, CA 92373
Phone (714) 766-5882

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1922433531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734609",
            "telephone_number": "909-792-8440",
            "fax_number": "909-792-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 BROOKSIDE AVE",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734609",
            "telephone_number": "909-792-8440",
            "fax_number": "909-792-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE DENTAL SPECIALTY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "909-792-8440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "50740",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.