Active NPI
Dominick Ventresca, D.M.D.
- Dentist
- Oakhurst, CA
National Provider Identifier
1033527825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63445
- Practice address
- 49185 Road 426
Oakhurst, CA 93644-9814 - Phone
- (559) 664-4000
- NPI assigned
- Jul 24, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 63445 | CA | Primary |
Addresses
Primary practice location
49185 Road 426
Oakhurst, CA 93644-9814
Mailing address
PO Box 482
Oakhurst, CA 93644-0482
Phone (310) 425-9180
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151120001472 | CA | Order and Referring Only - Oral Surgery | 1355641432 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63445 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1406160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713484800000",
"number": "1033527825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 482",
"city": "OAKHURST",
"state": "CA",
"postal_code": "936440482",
"telephone_number": "310-425-9180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49185 ROAD 426",
"city": "OAKHURST",
"state": "CA",
"postal_code": "936449814",
"telephone_number": "559-664-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VENTRESCA",
"first_name": "DOMINICK",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-07-24",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakhurst, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.