NPIMap

Organization Active NPI

Village Dental Care

  • Dental Clinic/Center
  • Riverside, CA
National Provider Identifier
1972922250
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
57425 Issued in CA
Legal business name
VILLAGE DENTAL CARE
Practice address
10925 Magnolia Ave
Riverside, CA 92505-3044
Phone
(951) 977-9991
Fax
(951) 588-8552
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
David O Medina, DDS
Title
President
Phone
(951) 977-9991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 57425 CA Primary

Addresses

Primary practice location

10925 Magnolia Ave
Riverside, CA 92505-3044

Mailing address

10925 Magnolia Ave
Riverside, CA 92505-3044
Phone (951) 977-9991

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1972922250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10925 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053044",
            "telephone_number": "951-977-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10925 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053044",
            "telephone_number": "951-977-9991",
            "fax_number": "951-588-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-977-9991",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CA",
            "license": "57425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.