Active NPI
Juan C Soto, DDS
- Dentist
- Modesto, CA
National Provider Identifier
1043876717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110306
- Practice address
- 1800 Tully Rd Ste A2
Modesto, CA 95350-2923 - Phone
- (209) 527-3990
- NPI assigned
- May 17, 2019
- 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 | 110306 | CA | Primary |
Addresses
Primary practice location
1800 Tully Rd Ste A2
Modesto, CA 95350-2923
Mailing address
1800 Tully Rd Ste A2
Modesto, CA 95350-2923
Phone (209) 527-3990
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 |
|---|---|---|---|
| 110306 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Momani DDS Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Livingston, CA
- NPI 1952238768
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738195200000",
"number": "1043876717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1800 TULLY RD STE A2",
"city": "MODESTO",
"state": "CA",
"postal_code": "953502923",
"telephone_number": "209-527-3990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 TULLY RD STE A2",
"city": "MODESTO",
"state": "CA",
"postal_code": "953502923",
"telephone_number": "209-527-3990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "JUAN",
"middle_name": "C",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-05-17",
"last_updated": "2025-01-30",
"certification_date": "2025-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.