Justin Namm Dental Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JUSTIN NAMM DENTAL CORPORATION

Practice address

1221 N State St Ste D
San Jacinto, CA 92583-6323

Phone

(951) 462-5751

Fax

(951) 465-2638

NPI assigned

Aug 16, 2022

Organization subpart

No

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

Authorized official

Name

Justin Namm, DDS

Title

Owner

Phone

(951) 462-5751

Specialties & licenses 1

Addresses

Other names 1

• Dentists of San Jacinto Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Minh Ngoc Chau, D.D.S.

  • General Practice Dentistry
  • San Jacinto, CA
  • NPI 1679393680
  NPD

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660608000000",
    "number": "1972221034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920050",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920050",
            "telephone_number": "714-845-8890",
            "fax_number": "303-952-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 N STATE ST STE D",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925836323",
            "telephone_number": "951-462-5751",
            "fax_number": "951-465-2638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN NAMM DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A",
        "authorized_official_last_name": "NAMM",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "951-462-5751",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dentists of San Jacinto",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Annette Jones
• Joycelynn Mariah Jones
• Christine Jordan, LPT
• Ralph Jorge
• JS Medical Transport
• K&Y Community Base Service
• Michele Kamphuis, CADC, WTS
• Neil Katchman, D.O.
• Robert Carl Ketchum, CATC1
• Gene Kim, PHARMD

• General Practice Dentistry in San Jacinto, CA
• Providers in San Jacinto, 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 Aug 16, 2022; 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.