Individual provider Active NPI

Michal Staninec, DDS, PHD

  • Dentist
  • San Francisco, CA
National Provider Identifier
1124264411
Registry record updated Dec 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL029483 Issued in CA
Practice address
3580 California St
Suite 204
San Francisco, CA 94118-1717
Phone
(415) 563-2022
Fax
(415) 781-7819
NPI assigned
Dec 17, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL029483 CA Primary

Addresses

Primary practice location

3580 California St
Suite 204
San Francisco, CA 94118-1717

Mailing address

3580 California St.
Suite 204
San Francisco, CA 94118-1717
Phone (415) 563-2022

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DL029483CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481846400000",
    "number": "1124264411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 CALIFORNIA ST.",
            "address_2": "SUITE 204",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181717",
            "telephone_number": "415-563-2022",
            "fax_number": "415-771-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 CALIFORNIA ST",
            "address_2": "SUITE 204",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181717",
            "telephone_number": "415-563-2022",
            "fax_number": "415-781-7819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANINEC",
        "first_name": "MICHAL",
        "name_prefix": "Dr.",
        "credential": "DDS, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-17",
        "last_updated": "2016-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DL029483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.