Active NPI
Diko Androus Diko, D.D.S
- General Practice Dentistry
- Modesto, CA
National Provider Identifier
1164449005
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 49511
- Practice address
- 3848 McHenry Ave Ste 130
Modesto, CA 95356-1599 - Phone
- (209) 523-2100
- Fax
- (209) 523-2101
- NPI assigned
- Jul 16, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 49511 | CA | Primary |
Addresses
Primary practice location
3848 McHenry Ave Ste 130
Modesto, CA 95356-1599
Mailing address
3848 McHenry Ave Ste 130
Modesto, CA 95356-1599
Phone (209) 523-2100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B49511-01 | Other | CA | DELTADENTAL OF CALIFORNIA |
| G93045-01 | Other | CA | DENTI-CAL |
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 |
|---|---|---|---|
| 49511 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Jotsna'S Dental Office | General Practice | Past | Accepting new patients |
| Diko a Diko | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Modesto, CA
- NPI 1891180642
-
- General Practice Dentistry
- Modesto, CA
- NPI 1407367824
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427673600000",
"number": "1164449005",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3848 MCHENRY AVE STE 130",
"city": "MODESTO",
"state": "CA",
"postal_code": "953561599",
"telephone_number": "209-523-2100",
"fax_number": "209-523-2101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3848 MCHENRY AVE STE 130",
"city": "MODESTO",
"state": "CA",
"postal_code": "953561599",
"telephone_number": "209-523-2100",
"fax_number": "209-523-2101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIKO",
"first_name": "DIKO",
"middle_name": "ANDROUS",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2015-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "49511",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTADENTAL OF CALIFORNIA",
"identifier": "B49511-01",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL",
"identifier": "G93045-01",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.