Active NPI
Holly Katherine Aguigam, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1083023444
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63768
- Practice address
- 2619 Clairemont Dr
San Diego, CA 92117-6634 - Phone
- (424) 256-5192
- NPI assigned
- Aug 10, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 63768 | CA | Primary |
Addresses
Primary practice location
2619 Clairemont Dr
San Diego, CA 92117-6634
Mailing address
12773 Cijon St
San Diego, CA 92129-3024
Phone (424) 256-5192
Other practice location 1
15835 Pomerado Rd Ste 301
Poway, CA 92064-2043
Phone (858) 487-4888
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
| License | State | Type | Specialty |
|---|---|---|---|
| 63768 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696723200000",
"number": "1083023444",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12773 CIJON ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921293024",
"telephone_number": "424-256-5192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2619 CLAIREMONT DR",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921176634",
"telephone_number": "424-256-5192"
}
],
"practiceLocations": [
{
"address_1": "15835 Pomerado Rd Ste 301",
"address_purpose": "LOCATION",
"city": "Poway",
"state": "CA",
"postal_code": "920642043",
"country_code": "US",
"telephone_number": "858-487-4888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AGUIGAM",
"first_name": "HOLLY",
"middle_name": "KATHERINE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-10",
"last_updated": "2023-10-08",
"certification_date": "2023-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.