Active NPI
Gary R. Amatangelo, D.D.S.
- Dentist
- Olivehurst, CA
National Provider Identifier
1124002852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 027863
- Practice address
- 4941 Olivehurst Ave
Olivehurst, CA 95961-4225 - Phone
- (530) 743-4614
- Fax
- (530) 743-1883
- NPI assigned
- Dec 6, 2005
- Sex
- Male
- 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 | 027863 | CA | Primary |
Addresses
Primary practice location
4941 Olivehurst Ave
Olivehurst, CA 95961-4225
Mailing address
PO Box a D
Yuba City, CA 95992-1396
Phone (530) 751-3769
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027863 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133827200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309478400000",
"number": "1124002852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX A D",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959921396",
"telephone_number": "530-751-3769",
"fax_number": "530-751-1237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4941 OLIVEHURST AVE",
"city": "OLIVEHURST",
"state": "CA",
"postal_code": "959614225",
"telephone_number": "530-743-4614",
"fax_number": "530-743-1883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMATANGELO",
"first_name": "GARY",
"middle_name": "R.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-06",
"last_updated": "2011-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "027863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olivehurst, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.