Active NPI
Rose Magno, DDS
- Dentist
- Emeryville, CA
National Provider Identifier
1124405238
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 42177
- Practice address
- 6001 Shellmound St Ste 125
Emeryville, CA 94608-1924 - Phone
- (510) 595-1600
- NPI assigned
- Apr 28, 2015
- Last updated
- Apr 28, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 42177 | CA | Primary |
Addresses
Primary practice location
6001 Shellmound St Ste 125
Emeryville, CA 94608-1924
Mailing address
6001 Shellmound St Ste 125
Emeryville, CA 94608-1924
Phone (510) 595-1600
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
| License | State | Type | Specialty |
|---|---|---|---|
| 42177 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1430179200000",
"number": "1124405238",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6001 SHELLMOUND ST STE 125",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081924",
"telephone_number": "510-595-1600"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6001 SHELLMOUND ST STE 125",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081924",
"telephone_number": "510-595-1600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGNO",
"first_name": "ROSE",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-28",
"last_updated": "2015-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "42177",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Emeryville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.