Active NPI
Jennifer L Vitez, DMD
- Dentist
- Pasadena, CA
National Provider Identifier
1174837538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59286
- Practice address
- 1845 N Fair Oaks Ave
St. 1101
Pasadena, CA 91103-1620 - Phone
- (626) 744-6350
- NPI assigned
- Jul 28, 2010
- Sex
- Female
- Sole proprietor
- No
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 | 59286 | CA | Primary |
Addresses
Primary practice location
1845 N Fair Oaks Ave
St. 1101
Pasadena, CA 91103-1620
Mailing address
1845 N Fair Oaks Ave
St 1101
Pasadena, CA 91103-1620
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 |
|---|---|---|---|
| 59286 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1280275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1174837538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1845 N FAIR OAKS AVE",
"address_2": "ST 1101",
"city": "PASADENA",
"state": "CA",
"postal_code": "911031620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1845 N FAIR OAKS AVE",
"address_2": "ST. 1101",
"city": "PASADENA",
"state": "CA",
"postal_code": "911031620",
"telephone_number": "626-744-6350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITEZ",
"first_name": "JENNIFER",
"middle_name": "L",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-28",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.