Individual provider Active NPI

Edward Joseph Formica, D.D.S.

  • Dentist
  • Hemet, CA
National Provider Identifier
1124114897
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
38280 Issued in CA
Practice address
1303 S State St
Hemet, CA 92543-7624
Phone
(951) 925-6444
Fax
(951) 848-9443
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 38280 CA Primary

Addresses

Primary practice location

1303 S State St
Hemet, CA 92543-7624

Mailing address

1303 S State St
Hemet, CA 92543-7624
Phone (951) 925-6444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
38280CAMDLicensed Psychiatric Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward J Formica D.D.S., Inc. CurrentSince Apr 1, 2024 Accepting new patients

Locations

1303 S State St
Hemet, CA 92543
Phone (951) 925-6444

1800 E Florida Ave
Ste 340
Hemet, CA 92544

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1124114897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437624",
            "telephone_number": "951-925-6444",
            "fax_number": "951-848-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 S STATE ST",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925437624",
            "telephone_number": "951-925-6444",
            "fax_number": "951-848-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORMICA",
        "first_name": "EDWARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "38280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hemet, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.