Individual provider Active NPI

Alexandre Amro, DDS

  • Dentist
  • Merced, CA
National Provider Identifier
1104603992
Registry record updated Sep 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109314 Issued in CA
Practice address
554 W 25TH St
Merced, CA 95340-2828
Phone
(650) 664-7826
NPI assigned
Sep 13, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109314 CA Primary

Addresses

Primary practice location

554 W 25TH St
Merced, CA 95340-2828

Mailing address

554 W 25TH St
Merced, CA 95340-2828
Phone (650) 664-7826

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
I20240129003950 CA Order and Referring Only - DentistPractitioner - Dentist 6204289952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1104603992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 W 25TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953402828",
            "telephone_number": "650-664-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "554 W 25TH ST",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953402828",
            "telephone_number": "650-664-7826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMRO",
        "first_name": "ALEXANDRE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

Verify at the official NPI Registry.