Individual provider Active NPI

Steve Longoria, D.D.S.

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1063581973
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43366 Issued in CA
Practice address
1568 Creekside Dr
Suite 205
Folsom, CA 95630-3449
Phone
(916) 983-2900
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 43366 CA Primary

Addresses

Primary practice location

1568 Creekside Dr
Suite 205
Folsom, CA 95630-3449

Mailing address

1568 Creekside Dr
Suite 205
Folsom, CA 95630-3449
Phone (916) 983-2900

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
I20160613000801 CA Order and Referring Only - DentistPractitioner - Dentist 1850681313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43366CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063581973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR",
            "address_2": "SUITE 205",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449",
            "telephone_number": "916-983-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1568 CREEKSIDE DR",
            "address_2": "SUITE 205",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303449",
            "telephone_number": "916-983-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONGORIA",
        "first_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.