Victor J. Costanza

Primary specialty

DentistTaxonomy code 122300000X

License

39780 Issued in CA

Legal business name

VICTOR J. COSTANZA

Practice address

4655 Hoen Ave
Santa Rosa, CA 95405-7800

Phone

(707) 545-7575

Fax

(707) 545-7575

NPI assigned

Jan 18, 2007

Last updated

Jun 8, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Victor J Costanza

Title

Owner

Phone

(707) 545-7575

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1073665949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057800",
            "telephone_number": "707-545-7575",
            "fax_number": "707-545-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 HOEN AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954057800",
            "telephone_number": "707-545-7575",
            "fax_number": "707-545-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICTOR J. COSTANZA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "COSTANZA",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-545-7575"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudia Ann Viadro, MFT
• Marina I Vicario
• Margarita Vicencio
• Katherine R. Vickery, MD
• Kathryn Elizabeth Vickery, PPS, NCSP
• Victor Treatment Center
• Victor Treatment Center
• Victor Treatment Centers, Inc.
• Victor Treatment Centers, Inc.
• Victor Treatment Centers, Inc.

• Dentist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.