1043532765 NPI number — ADAME & ADAME, D.D.S.

Table of content: DR. CHARLES EDWARD GARTEN II M.D. (NPI 1942234281)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043532765 NPI number — ADAME & ADAME, D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAME & ADAME, D.D.S.
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:
Provider Other Organization Name Type Code:
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:
1043532765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2155 NORTH ARROWHEAD AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN BERNARDINO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92405-4001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
909-886-1144
Provider Business Mailing Address Fax Number:
909-886-8726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2155 NORTH ARROWHEAD AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN BERNARDINO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92405-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
909-886-1144
Provider Business Practice Location Address Fax Number:
909-886-8726
Provider Enumeration Date:
02/22/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ADAME
Authorized Official First Name:
SAMUEL
Authorized Official Middle Name:
FILIPPINI
Authorized Official Title or Position:
DENTIST/PARTNER
Authorized Official Telephone Number:
909-886-1144

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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