NPIMap

Organization Active NPI

Southwest Dental Center Inc.

Doing business as Hi Desert Dental Center

  • General Practice Dentistry
  • Lancaster, CA
National Provider Identifier
1942442777
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32936 Issued in CA
Legal business name
SOUTHWEST DENTAL CENTER INC.
Doing business as
Hi Desert Dental Center
Practice address
1745 W Avenue K
Suite C
Lancaster, CA 93534-6501
Phone
(661) 723-5400
Fax
(661) 723-3944
NPI assigned
Mar 25, 2009
Reactivated
Jul 27, 2016
Last updated
Jul 27, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTHWEST DENTAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Authorized official

Name
Dr. Leoneed Gordon, D.D.SNPI 1013094135
Title
Owner
Phone
(661) 723-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43266 CA
General Practice Dentistry 1223G0001X 32936 CA Primary

Addresses

Primary practice location

1745 W Avenue K
Suite C
Lancaster, CA 93534-6501

Mailing address

1745 W Avenue K
Suite C
Lancaster, CA 93534-6501
Phone (661) 723-5400

Other identifiers 3

IdentifierTypeStateIssuer
32936OtherCALICENSE
43622OtherCALICENSE
571310977OtherCAGORDON

Other names 1

  • HI DESERT DENTAL CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southwest Dental Center Inc2 organizations share this tax ID, including this one
Part of
Southwest Dental Center Inc

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1942442777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1745 W AVENUE K",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346501",
            "telephone_number": "661-723-5400",
            "fax_number": "661-723-3944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 W AVENUE K",
            "address_2": "SUITE C",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935346501",
            "telephone_number": "661-723-5400",
            "fax_number": "661-723-3944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DENTAL CENTER INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHWEST DENTAL CENTER",
        "enumeration_date": "2009-03-25",
        "last_updated": "2016-07-27",
        "deactivation_date": "2009-07-10",
        "reactivation_date": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "LEONEED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "661-723-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43266",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "32936",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "43622",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GORDON",
            "identifier": "571310977",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HI DESERT DENTAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; 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.