Jacqueline L Subka, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

44545 Issued in CA

Practice address

425 Haaland Dr
Suite 202
Thousand Oaks, CA 91361

Phone

(805) 373-1919

Fax

(805) 373-2083

NPI assigned

Oct 19, 2006

Last updated

Jan 28, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1144302035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HAALAND DR.",
            "address_2": "SUITE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91361",
            "telephone_number": "805-373-1919",
            "fax_number": "805-373-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 HAALAND DR",
            "address_2": "SUITE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91361",
            "telephone_number": "805-373-1919",
            "fax_number": "805-373-2083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBKA",
        "first_name": "JACQUELINE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.