Individual provider Active NPI

Pamela Marie Andrews, DDS

  • General Practice Dentistry
  • Manteca, CA
National Provider Identifier
1144587601
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37529 Issued in CA
Practice address
132 N Grant Ave
Manteca, CA 95336-4601
Phone
(209) 239-5996
Fax
(209) 824-8116
NPI assigned
Apr 20, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 37529 CA Primary

Addresses

Primary practice location

132 N Grant Ave
Manteca, CA 95336-4601

Mailing address

132 N Grant Ave
Manteca, CA 95336-4601
Phone (209) 239-5996

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150313002202 CA Order and Referring Only - DentistPractitioner - Dentist 7911223797

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334880000000",
    "number": "1144587601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 N GRANT AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364601",
            "telephone_number": "209-239-5996",
            "fax_number": "209-824-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 N GRANT AVE",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364601",
            "telephone_number": "209-239-5996",
            "fax_number": "209-824-8116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDREWS",
        "first_name": "PAMELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.