Individual provider Active NPI

Emilia Lavinia Dinea-Berci, D.D.S.

  • Dentist
  • Roseville, CA
National Provider Identifier
1104374206
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS100602 Issued in CA
Practice address
1259 Pleasant Grove Blvd Ste 100
Roseville, CA 95678-6974
Phone
(916) 782-2010
NPI assigned
Sep 17, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DDS100602 CA Primary

Addresses

Primary practice location

1259 Pleasant Grove Blvd Ste 100
Roseville, CA 95678-6974

Mailing address

3634 Whitney Ave
Sacramento, CA 95821-3128
Phone (916) 782-2010

Other identifiers 1

IdentifierTypeStateIssuer
DDS100602OtherCADENTAL BOARD OF CALIFORNIA

Other names 1

  • Lavinia Berci Professional name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170228000957 CA Order and Referring Only - DentistPractitioner - Dentist 1951685502

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS100602CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Corporation of Charles Rodgers and Carolyn Ghazal 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1474070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1104374206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3634 WHITNEY AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958213128",
            "telephone_number": "916-782-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 PLEASANT GROVE BLVD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956786974",
            "telephone_number": "916-782-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINEA-BERCI",
        "first_name": "EMILIA",
        "middle_name": "LAVINIA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS100602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL BOARD OF CALIFORNIA",
            "identifier": "DDS100602",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAVINIA",
            "last_name": "BERCI",
            "credential": "D.D.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.