Joseph Olufemi Fagbamigbe
Individual provider Active NPI General Practice Dentistry · Corning, CA
NPI 1144950718 · NPPES record last updated Jun 15, 2022
Key facts
- NPI
- 1144950718
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 107514 (CA)
- Practice address
- 705 East St
Corning, CA 96021-2252 - Phone
- (530) 900-7550
- NPI assigned
- Jun 15, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230113001950 | CA | Practitioner - Dentist | 7719358555 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Feather River Tribal Health Inc | Current |
Accepting new patients |
Locations
2145 5th Ave
Oroville, CA 95965
Phone (530) 534-3793
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 107514 | CA | Yes |
Addresses
Primary practice location
705 East St
Corning, CA 96021-2252
Mailing address
1066 Toomes Ave
Corning, CA 96021-2718
Phone (312) 889-2222
Other providers in Corning, CA
- Susan J Eissinger
- Sofia B Elahi
- Elijah House Foundation
- Ali Emdadian
- David Ferris Essi IV
- Deborah Jean Fiedler
- Ashley Christine Heitland
- Jazmin Herrera-Placido
- Jeffrey Ryan Howell
- Felix U Ihekwoeme
All providers in Corning, CA · General Practice Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.