Individual provider Active NPI

Sharon Sampaga, DDS

  • General Practice Dentistry
  • Mission Viejo, CA
National Provider Identifier
1114080199
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38502 Issued in CA
Practice address
25523 Marguerite Pkwy
#C
Mission Viejo, CA 92692-2926
Phone
(949) 768-1800
Fax
(949) 768-0432
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
No

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 38502 CA Primary

Addresses

Primary practice location

25523 Marguerite Pkwy
#C
Mission Viejo, CA 92692-2926

Mailing address

PO Box 17179
Irvine, CA 92623-7179
Phone (949) 567-3176

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
I20150805007899 CA Order and Referring Only - DentistPractitioner - Dentist 4486968328

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38502CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cox Dental Corporation General Practice PastSince Jan 12, 2020 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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114080199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17179",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926237179",
            "telephone_number": "949-567-3176",
            "fax_number": "949-567-3185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25523 MARGUERITE PKWY",
            "address_2": "#C",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926922926",
            "telephone_number": "949-768-1800",
            "fax_number": "949-768-0432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMPAGA",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission Viejo, CA

Sources for this page

Verify at the official NPI Registry.