Individual provider Active NPI

Michael Eric Ortega, D.M.D.

  • General Practice Dentistry
  • Palmdale, CA
National Provider Identifier
1063852960
Registry record updated Jul 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
62476 Issued in CA
Practice address
38750 Trade Center Dr Ste J
Palmdale, CA 93551-3787
Phone
(661) 267-6400
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2015

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 62476 CA Primary

Addresses

Primary practice location

38750 Trade Center Dr Ste J
Palmdale, CA 93551-3787

Mailing address

41819 Montallegro St
Lancaster, CA 93536-2987
Phone (661) 317-7173

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
I20150915001709 CA Order and Referring Only - DentistPractitioner - Dentist 8820305444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sagisi DMD Inc General Practice Past Accepting new patients
Thanh Q. Nguyen Dental Corporation General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437004800000",
    "number": "1063852960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41819 MONTALLEGRO ST",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935362987",
            "telephone_number": "661-317-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38750 TRADE CENTER DR STE J",
            "city": "PALMDALE",
            "state": "CA",
            "postal_code": "935513787",
            "telephone_number": "661-267-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "MICHAEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2015-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "62476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmdale, CA

Sources for this page

Verify at the official NPI Registry.