Individual provider Active NPI

George E. Janeway Jr., D.D.S.

  • General Practice Dentistry
  • Los Osos, CA
National Provider Identifier
1073722716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21373 Issued in CA
Practice address
2238 Bayview Heights Dr
Suite F
Los Osos, CA 93402-3921
Phone
(805) 528-3000
Fax
(805) 528-3080
NPI assigned
May 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 21373 CA Primary

Addresses

Primary practice location

2238 Bayview Heights Dr
Suite F
Los Osos, CA 93402-3921

Mailing address

2238 Bayview Heights Dr
Suite F
Los Osos, CA 93402-3921
Phone (805) 528-3000

Other identifiers 1

IdentifierTypeStateIssuer
B21373-01OtherCAMEDI-CAL PROVIDER NUMBER

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
21373CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Duffy C. de Graw D.D.S. a Professional Corporation General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073722716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2238 BAYVIEW HEIGHTS DR",
            "address_2": "SUITE F",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023921",
            "telephone_number": "805-528-3000",
            "fax_number": "805-528-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2238 BAYVIEW HEIGHTS DR",
            "address_2": "SUITE F",
            "city": "LOS OSOS",
            "state": "CA",
            "postal_code": "934023921",
            "telephone_number": "805-528-3000",
            "fax_number": "805-528-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANEWAY",
        "first_name": "GEORGE",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "21373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "B21373-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Osos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.