Individual provider Active NPI

Aaron Brian Pitts, DMD

  • Student in an Organized Health Care Education/Training Program
  • Pine Valley, CA
National Provider Identifier
1174840284
Registry record updated Jun 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
39020000X Issued in CA
Practice address
28914 Old Hwy 80
Suite 104
Pine Valley, CA 91962
Phone
(619) 473-8735
Fax
(619) 473-8625
NPI assigned
Apr 28, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 39020000X CA Primary

Addresses

Primary practice location

28914 Old Hwy 80
Suite 104
Pine Valley, CA 91962

Mailing address

PO Box 839
28914 Old Hwy 80 Suite 104
Pine Valley, CA 91962
Phone (619) 473-8735

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
I20160209002022 CA Order and Referring Only - DentistPractitioner - Dentist 3779887997

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
39020000XCAMDClinical Social Worker
60347CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aaron B. Pitts, DMD Inc. PastSince Jun 12, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1272412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654387200000",
    "number": "1174840284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 839",
            "address_2": "28914 OLD HWY 80 SUITE 104",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "91962",
            "telephone_number": "619-473-8735",
            "fax_number": "619-473-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28914 OLD HWY 80",
            "address_2": "SUITE 104",
            "city": "PINE VALLEY",
            "state": "CA",
            "postal_code": "91962",
            "telephone_number": "619-473-8735",
            "fax_number": "619-473-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTS",
        "first_name": "AARON",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-28",
        "last_updated": "2022-06-05",
        "certification_date": "2022-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "39020000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Valley, CA

Sources for this page

Verify at the official NPI Registry.