BROCKTON DENTAL X-RAY LAB., INC.


Address: 6800 Brockton Ave Ste 3, Riverside, CA 92506-3810
Phone: 9516827505

BROCKTON DENTAL X-RAY LAB., INC. (NPI# 1467734491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1467734491
Entity Type Organization
Organization Name BROCKTON DENTAL X-RAY LAB., INC.
Practice Address 6800 Brockton Ave Ste 3
Riverside
CA 92506-3810
Practice Telephone 9516827505
Practice Fax Number 9516827549
Mailing Telephone 9516827505
Mailing Fax Number 9516827549
Enumeration Date 2011-09-15
Last Update Date 2011-09-15
Authorized Official Name MICHAEL W. CARPENTER (OWNER)
Authorized Official Telephone 9516827505
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 292200000X Dental Laboratory RHP7971 CA Laboratories
Y 292200000X Dental Laboratory RHP00050468 CA Laboratories

Office Location

Street Address 6800 BROCKTON AVE STE 3
City RIVERSIDE
State CA
Zip Code 92506-3810

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1922542273 Yazmar Sevilla-perez Physical Therapist 6852 Brockton Ave., Suite 212, Riverside, CA 92506 2016-12-06
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Taxonomy Information

Taxonomy Code 292200000X
Grouping Laboratories
Classification Dental Laboratory

Taxonomy Definition

A commercial laboratory specializing in the construction of dental appliances that conform to a dentist’s specifications including the construction of dentures (complete or partial), orthodontic appliances, bridgework, crowns, and inlays.
Notes: Source: Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 1245.

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1427587724 California Dental Arts, LLC Dental Laboratory 20421 Pacifica Dr, Cupertino, CA 95014-3013 2017-06-08
1366807950 C-dental X-ray, Inc Dental Laboratory 1900 Olympic Blvd, Ste. 201, Walnut Creek, CA 94596-5037 2015-12-23
1932576220 Dental Digital Design Dental Laboratory 17781 Sky Park Cir # D, Irvine, CA 92614-6103 2015-08-21
1245606847 C-dental X-ray, Inc. Dental Laboratory 362 W Portal Ave, San Francisco, CA 94127-1412 2015-08-18
1750757696 C-dental X-ray, Inc. Dental Laboratory 1475 Cedarwood Ln, Ste. D, Pleasanton, CA 94566-6153 2015-08-14
1639588205 John Bilder Fund Billingsworth Lab Dental Laboratory 7202 Greenleaf Ave, 13303 Philadelphia St, Whittier, CA 90602-1312 2014-08-08
1588915615 Usc Redmond Imaging Center Dental Laboratory 925 W 34th St Ste 319, Los Angeles, CA 90089-0641 2012-09-28
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Competitor

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City RIVERSIDE
Zip Code 92506

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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