Individual provider Active NPI

Vincent John Tso, DMD

  • Prosthodontics
  • South Pasadena, CA
National Provider Identifier
1043201726
Registry record updated Mar 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
34243 Issued in CA
Practice address
627 Fremont Ave
South Pasadena, CA 91030-2527
Phone
(626) 799-6255
NPI assigned
Nov 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 34243 CA Primary

Addresses

Primary practice location

627 Fremont Ave
South Pasadena, CA 91030-2527

Mailing address

627 Fremont Ave
South Pasadena, CA 91030-2527
Phone (626) 799-6255

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070718000644 CA Practitioner - Oral Surgery 4183725336 Practice locations: South Pasadena, CA

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1985
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

627 Fremont Ave
South Pasadena, CA 91030-2527
Phone (626) 799-6255

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206921600000",
    "number": "1043201726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "627 FREMONT AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302527",
            "telephone_number": "626-799-6255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "627 FREMONT AVE",
            "city": "SOUTH PASADENA",
            "state": "CA",
            "postal_code": "910302527",
            "telephone_number": "626-799-6255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TSO",
        "first_name": "VINCENT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "34243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Pasadena, CA

Sources for this page

Verify at the official NPI Registry.