| Pomona Dental Practice | |
|
1640 Indian Hill Blvd Pomona CA 91767-3728 | |
| (909) 482-4500 | |
| (909) 482-4502 |
| Full Name | Pomona Dental Practice |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1640 Indian Hill Blvd, Pomona, California |
| Authorized Official Name and Position | Yvonne Shu Rodriguez (PRESIDENT/ OWNER) |
| Authorized Official Contact | 9094824500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pomona Dental Practice 1640 Indian Hill Blvd Pomona CA 91767-3728 Ph: (909) 482-4500 | Pomona Dental Practice 1640 Indian Hill Blvd Pomona CA 91767-3728 Ph: (909) 482-4500 |
| NPI Number | 1366599060 |
|---|---|
| Provider Enumeration Date | 01/04/2007 |
| Last Update Date | 04/07/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366599060 | NPI | - | NPPES |
| 771913 | Other | CA | UNITED CONCORDIA |
| D41547 | Medicaid | CA | |
| B41547 | Other | CA | HEALTHY FAMILIES |
| G9220601 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 41547 (California) | Primary |
Larissa Gushansky, Dds Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 887 E 2nd St, Suite B, Pomona, CA 91766 Phone: 909-865-8595 | |
Pravinchandra Makadia Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 826 E Mission Blvd, Pomona, CA 91766 Phone: 909-622-1817 Fax: 909-622-8750 | |
Miro Itskovich, Dds Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 847 Philadelphia St., Pomona, CA 91766 Phone: 909-927-4177 | |
Dr. Mehta's Grove Dental Office Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3167 N. Garey Ave, Pomona, CA 91767 Phone: 909-596-7700 Fax: 909-392-4697 | |
Jeffrey B. Thomas, D.d.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 160 E Artesia St, Suite 125, Pomona, CA 91767 Phone: 909-622-1261 | |
Larissa Gushansky, Dds Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 887 E 2nd St Ste D, Pomona, CA 91766 Phone: 909-865-8595 | |
Pravinchandra Makadia Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 826 E Mission Blvd, Pomona, CA 91766 Phone: 909-996-6924 Fax: 909-622-8750 |