Individual provider Active NPI

Alicia Marie Schexnayder, DDS

  • General Practice Dentistry
  • Fairfield, CA
National Provider Identifier
1184093445
Registry record updated Sep 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
64994 Issued in CA
Practice address
3332 N Texas St Ste C
Fairfield, CA 94533-9758
Phone
(707) 399-9082
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2015

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 64994 CA Primary

Addresses

Primary practice location

3332 N Texas St Ste C
Fairfield, CA 94533-9758

Mailing address

203 Coggins Dr Apt A114
Pleasant Hill, CA 94523-4540

Other names 1

  • Alicia Marie Citi Former name

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
I20161019002135 CA Order and Referring Only - DentistPractitioner - Dentist 0648568907

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64994CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1184093445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 COGGINS DR APT A114",
            "city": "PLEASANT HILL",
            "state": "CA",
            "postal_code": "945234540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3332 N TEXAS ST STE C",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945339758",
            "telephone_number": "707-399-9082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEXNAYDER",
        "first_name": "ALICIA",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "CITI",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.