Dr. Werner Visage DDS, Inc.

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

DR. WERNER VISAGE DDS, INC.

Doing business as

Marconi Dental Group

Practice address

6440 Fair Oaks Blvd
Carmichael, CA 95608-4019

Phone

(916) 487-7148

Fax

(916) 487-1468

NPI assigned

Aug 18, 2020

Organization subpart

No

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

Authorized official

Name

Yuriy Timonichev

Title

Admin Lead

Phone

(916) 487-1468

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Marconi Dental Group Doing business as

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Werner Visage, DDS

  • Dentist
  • Oakland, CA
  • NPI 1639622848
  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1043822380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6440 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956084019",
            "telephone_number": "916-487-7148",
            "fax_number": "916-487-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 FAIR OAKS BLVD",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956084019",
            "telephone_number": "916-487-7148",
            "fax_number": "916-487-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. WERNER VISAGE DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-18",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "TIMONICHEV",
        "authorized_official_first_name": "YURIY",
        "authorized_official_title_or_position": "ADMIN LEAD",
        "authorized_official_telephone_number": "916-487-1468"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI1",
            "identifier": "1639622848",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "marconidentalgroup.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website",
            "address_1": "6440 Fair Oaks Blvd",
            "city": "Carmichael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956084019",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "edna@marconidentalgroup.com",
            "affiliation": "N",
            "endpointDescription": "Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "6440 Fair Oaks Blvd",
            "city": "Carmichael",
            "state": "CA",
            "country_code": "US",
            "postal_code": "956084019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Marconi Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Carmichael, CA
• Providers in Carmichael, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; 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.