1558637918 NPI number — DALE E. STRINGER D.D.S., INC.

Table of content: (NPI 1558637918)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558637918 NPI number — DALE E. STRINGER D.D.S., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DALE E. STRINGER D.D.S., 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:
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:
1558637918
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6860 BROCKTON AVENUE
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
RIVERSIDE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92506-3821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
951-787-0602
Provider Business Mailing Address Fax Number:
951-787-1830

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6860 BROCKTON AVENUE
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
RIVERSIDE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92506-3812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
951-787-0602
Provider Business Practice Location Address Fax Number:
951-787-1830
Provider Enumeration Date:
03/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
STRINGER
Authorized Official First Name:
DALE
Authorized Official Middle Name:
EDWARD
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
951-787-0602

Provider Taxonomy Codes

  • Taxonomy code: 1223S0112X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223S0112X , with the licence number: D27930 , 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)

  • Identifier: B2793001 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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