Individual provider Active NPI

Alexander James Corondoni, D.D.S.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1013045186
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38662 Issued in CA
Practice address
7424 Jackson Dr Ste 2
San Diego, CA 92119-2324
Phone
(619) 461-9499
Fax
(619) 461-7809
NPI assigned
Mar 1, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38662 CA Primary

Addresses

Primary practice location

7424 Jackson Dr Ste 2
San Diego, CA 92119-2324

Mailing address

6724 Dwane Ave
San Diego, CA 92120-3931
Phone (619) 203-2068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38662CAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013045186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6724 DWANE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203931",
            "telephone_number": "619-203-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7424 JACKSON DR STE 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921192324",
            "telephone_number": "619-461-9499",
            "fax_number": "619-461-7809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONDONI",
        "first_name": "ALEXANDER",
        "middle_name": "JAMES",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.