Active NPI
Tricia David Bato, D.D.S.
- Periodontics
- Mission Viejo, CA
National Provider Identifier
1073783650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 53695
- Practice address
- 26800 Crown Valley Pkwy
Ste 375
Mission Viejo, CA 92691-6384 - Phone
- (949) 388-3877
- NPI assigned
- Mar 10, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 53695 | CA | Primary |
Addresses
Primary practice location
26800 Crown Valley Pkwy
Ste 375
Mission Viejo, CA 92691-6384
Mailing address
19300 Braes River Dr
Walnut, CA 91789-4234
Phone (626) 912-7209
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160620001957 | CA | Order and Referring Only - Dentist | 9335430487 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53695 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259712000000",
"number": "1073783650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19300 BRAES RIVER DR",
"city": "WALNUT",
"state": "CA",
"postal_code": "917894234",
"telephone_number": "626-912-7209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26800 CROWN VALLEY PKWY",
"address_2": "STE 375",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926916384",
"telephone_number": "949-388-3877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATO",
"first_name": "TRICIA",
"middle_name": "DAVID",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-10",
"last_updated": "2009-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "53695",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.