1467590521 NPI number — REY P. JOVES DMD, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467590521 NPI number — REY P. JOVES DMD, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REY P. JOVES DMD, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MISSION PLAZA DENTAL
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467590521
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6879 MISSION ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALY CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94014-2034
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-756-8400
Provider Business Mailing Address Fax Number:
650-756-8470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6879 MISSION ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALY CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94014-2034
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-756-8400
Provider Business Practice Location Address Fax Number:
650-756-8470
Provider Enumeration Date:
02/02/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JOVWES
Authorized Official First Name:
REY
Authorized Official Middle Name:
PULIDO
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
650-756-8400

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  43351 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)