| Loma Linda University School Of Dentistry | |
|
11092 Anderson St. Loma Linda University School Of Dentistry Loma Linda CA 92354 | |
| (909) 558-4613 | |
| (909) 558-4192 |
| Full Name | Loma Linda University School Of Dentistry |
|---|---|
| Speciality | Clinic/Center |
| Location | 11092 Anderson St., Loma Linda, California |
| Authorized Official Name and Position | Rodney Dale Neal (SR. VICE PRESIDENT) |
| Authorized Official Contact | 9095584543 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Loma Linda University School Of Dentistry 11092 Anderson St. Loma Linda University School Of Dentistry Loma Linda CA 92354 Ph: (909) 558-4613 | Loma Linda University School Of Dentistry 11092 Anderson St. Loma Linda University School Of Dentistry Loma Linda CA 92354 Ph: (909) 558-4613 |
| NPI Number | 1639270846 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 03/24/2020 |
| Medicare PECOS PAC ID | 7911971833 |
|---|---|
| Medicare Enrollment ID | O20040825000556 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639270846 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 7547 (California) | Primary |
| 261QS0112X | Clinic/center - Oral And Maxillofacial Surgery | 7547 (California) | Secondary |
| Provider Name | T Allan Darnell |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1073695367 PECOS PAC ID: 9133197270 Enrollment ID: I20040917000210 |
| Provider Name | Richard Henry Hart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447347901 PECOS PAC ID: 3274501325 Enrollment ID: I20040917000256 |
| Provider Name | Warren Richard Peters |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1871680314 PECOS PAC ID: 7517935661 Enrollment ID: I20040917000289 |
| Provider Name | Alan Herford |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1982755419 PECOS PAC ID: 8123062551 Enrollment ID: I20050615001081 |
| Provider Name | Carlos M Moretta |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1356507818 PECOS PAC ID: 5193908499 Enrollment ID: I20110324000080 |
| Provider Name | Jeffrey A Elo |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891883880 PECOS PAC ID: 5092978882 Enrollment ID: I20120514000647 |
| Provider Name | Jayini Thakker |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1386847648 PECOS PAC ID: 0345476818 Enrollment ID: I20131112001434 |
| Provider Name | Ariane Marie-mitchell |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1952408965 PECOS PAC ID: 4587724604 Enrollment ID: I20140306001133 |
| Provider Name | Murray Jacobs |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1558452607 PECOS PAC ID: 8426019449 Enrollment ID: I20140606001100 |
| Provider Name | Andre V Guerrero Fernandes |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1891937249 PECOS PAC ID: 8224343744 Enrollment ID: I20150813009310 |
| Provider Name | Anupama Grandhi |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1821185844 PECOS PAC ID: 8224285838 Enrollment ID: I20160707001140 |
| Provider Name | Ashish P Sharma |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1346651007 PECOS PAC ID: 2961756796 Enrollment ID: I20181114002741 |
| Provider Name | Jeffrey S Paxman |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1730576554 PECOS PAC ID: 4082943931 Enrollment ID: I20190903001195 |
| Provider Name | Chi T Viet |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1306157094 PECOS PAC ID: 3971840760 Enrollment ID: I20191111002771 |
| Provider Name | Adam O Shafik |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1336707462 PECOS PAC ID: 9931532306 Enrollment ID: I20211101001118 |
Dental Faculty Associates Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 25455 Barton Road, Suite 203b, Loma Linda, CA 92354 Phone: 909-558-6468 Fax: 909-558-6469 | |
Loma Linda Univeristy Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: Loma Linda University--school Of Dentistry, 11092 Anderson Street, Loma Linda, CA 92354 Phone: 909-558-4613 Fax: 909-558-4192 | |
Loma Linda University Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11092 Anderson Street, Loma Linda, CA 92354 Phone: 909-558-4613 Fax: 909-558-4192 | |
Loma Linda University Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11092 Anderson Street, Room 1147, Loma Linda, CA 92350 Phone: 909-558-4611 Fax: 909-558-0106 | |
Jino Park Dds Dental Corporation Dental Clinic Medicare: Medicare Enrolled Practice Location: 24950 Redlands Blvd Ste B, Loma Linda, CA 92354 Phone: 909-478-9777 Fax: 909-478-9526 | |
Loma Linda University School Of Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 24860 Taylor St, Loma Linda, CA 92354 Phone: 909-558-4613 Fax: 909-558-4192 | |
Loma Linda University School Of Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 11092 Anderson St, Loma Linda, CA 92350 Phone: 909-558-4613 Fax: 909-558-4192 |