Individual provider Active NPI

Josephine V Di Giacinto-Dovidio, D.D.S.

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1104855584
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45244 Issued in CA
Practice address
2045 Royal Ave
#230
Simi Valley, CA 93065-4665
Phone
(805) 522-9242
Fax
(805) 529-5030
NPI assigned
Jun 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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 45244 CA Primary

Addresses

Primary practice location

2045 Royal Ave
#230
Simi Valley, CA 93065-4665

Mailing address

2045 Royal Ave
#230
Simi Valley, CA 93065-4665
Phone (805) 522-9242

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
I20150720002615 CA Order and Referring Only - DentistPractitioner - Dentist 8921311903

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45244CAMDPulmonary Rehabilitation Registered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Josephine Digiacinto Dovidio DDS 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": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104855584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE",
            "address_2": "#230",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654665",
            "telephone_number": "805-522-9242",
            "fax_number": "805-529-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 ROYAL AVE",
            "address_2": "#230",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930654665",
            "telephone_number": "805-522-9242",
            "fax_number": "805-529-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI GIACINTO-DOVIDIO",
        "first_name": "JOSEPHINE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

Verify at the official NPI Registry.