Individual provider Active NPI

Carmen Agapin Magpantay

  • Dentist
  • Northridge, CA
National Provider Identifier
1063550838
Registry record updated Jan 28, 2016
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
48324 Issued in CA
Practice address
10321 Zelzah Ave
Northridge, CA 91326-3507
Phone
(818) 366-4118
Fax
(818) 366-6098
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 48324 CA Primary

Addresses

Primary practice location

10321 Zelzah Ave
Northridge, CA 91326-3507

Mailing address

10321 Zelzah Ave
Northridge, CA 91326-3507
Phone (818) 366-4118

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
I20160121000839 CA Order and Referring Only - DentistPractitioner - Dentist 5092018242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48324CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453939200000",
    "number": "1063550838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10321 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913263507",
            "telephone_number": "818-366-4118",
            "fax_number": "818-366-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10321 ZELZAH AVE",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913263507",
            "telephone_number": "818-366-4118",
            "fax_number": "818-366-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGPANTAY",
        "first_name": "CARMEN",
        "middle_name": "AGAPIN",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2016-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "48324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.