Active NPI
James A Forester, DDS
- Pediatric Dentistry
- San Luis Obispo, CA
National Provider Identifier
1013075159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 50253
- Practice address
- 620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541 - Phone
- (805) 592-2020
- Fax
- (805) 592-2022
- NPI assigned
- Dec 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 02938 | RI | |
| Pediatric Dentistry | 1223P0221X | 50253 | CA | Primary |
Addresses
Primary practice location
620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541
Mailing address
620 California Blvd
Suite G
San Luis Obispo, CA 93401-2541
Phone (805) 592-2020
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 50253 | Other | CA | DENTAL LICENSE |
| 02938 | Other | RI | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02938 | RI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Newsom Forester Dental Partnership | Pediatric Dentistry | Past | Accepting new patients |
| Forester DDS Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Luis Obispo, CA
- NPI 1518430800
-
- Pediatric Dentistry
- San Luis Obispo, CA
- NPI 1790127173
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165190400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389830400000",
"number": "1013075159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 CALIFORNIA BLVD",
"address_2": "SUITE G",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012541",
"telephone_number": "805-592-2020",
"fax_number": "805-592-2022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 CALIFORNIA BLVD",
"address_2": "SUITE G",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012541",
"telephone_number": "805-592-2020",
"fax_number": "805-592-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORESTER",
"first_name": "JAMES",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-04",
"last_updated": "2014-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "RI",
"license": "02938",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "50253",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "50253",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "02938",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Luis Obispo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.