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Contact Information

JORGE L. GERONIMO, DDS PROF. DENTAL CORP.
9720 MAGNOLIA AVE SUITE #100
RIVERSIDE, CA92503
 Phone: 951-696-3663
 Fax: 951-696-3887
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for JORGE L. GERONIMO, DDS PROF. DENTAL CORP.

NPI # 1265809065
LBN Legal business name JORGE L. GERONIMO, DDS PROF. DENTAL CORP.
Authorized official JORGE GERONIMO - (DENTIST)
Entity Organization
Organization subpart 1 Yes
Enumeration date 08/27/2015
Last updated 01/03/2020 - About 6 years ago
Identifiers
CA License # 47897
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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