Cadalso Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30639 Issued in CA

Legal business name

CADALSO DENTAL CORPORATION

Practice address

4380 Holt Blvd Ste E
Montclair, CA 91763-5407

Phone

(909) 626-1100

Fax

(909) 626-1120

NPI assigned

May 5, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Robert T Cadalso Jr., D.D.S.

Title

President

Phone

(909) 626-1100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• American Dental Care Doing business as

Locations

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

{
    "created_epoch": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1962794107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4380 HOLT BLVD STE E",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917635407",
            "telephone_number": "909-626-1100",
            "fax_number": "909-626-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4380 HOLT BLVD STE E",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917635407",
            "telephone_number": "909-626-1100",
            "fax_number": "909-626-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADALSO DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "CADALSO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-626-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30639",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "30639",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI",
            "identifier": "1003934761",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donald Cabrera Jr.
• Lizbeth Cabrera
• Marina Cabrera
• Susana Cabrera
• Joseph Dumincil Cachapero
• Calcare Home Health LLC
• Salma Giselle Calderon Rodas
• Janet Calderon
• Kayla Calderon
• California Professional Care

• General Practice Dentistry in Montclair, CA
• Providers in Montclair, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.