Individual provider Active NPI

Andrea Belen Arriaga

  • Dentist
  • San Luis Obispo, CA
National Provider Identifier
1073320222
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS111186 Issued in CA
Practice address
3870 Broad St Ste 1
San Luis Obispo, CA 93401-7172
Phone
(805) 309-0467
NPI assigned
Dec 11, 2024
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS111186 CA Primary

Addresses

Primary practice location

3870 Broad St Ste 1
San Luis Obispo, CA 93401-7172

Mailing address

2507 Solano Rd
Pismo Beach, CA 93449-1750
Phone (858) 829-8559

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

LicenseStateTypeSpecialty
DDS111186CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1733875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1073320222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2507 SOLANO RD",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934491750",
            "telephone_number": "858-829-8559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 BROAD ST STE 1",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934017172",
            "telephone_number": "805-309-0467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARRIAGA",
        "first_name": "ANDREA",
        "middle_name": "BELEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-11",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS111186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.

Verify at the official NPI Registry.