Active NPI
Alexander Joseph Vidunas
- Dentist
- Camp Pendleton, CA
National Provider Identifier
1194358747
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS042748
- Practice address
- Naval Hospital Camp Pendleton
Mercy Circle
Camp Pendleton, CA 92055-5191 - Phone
- (570) 490-2400
- NPI assigned
- Feb 21, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS042748 | PA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X |
Addresses
Primary practice location
Naval Hospital Camp Pendleton
Mercy Circle
Camp Pendleton, CA 92055-5191
Mailing address
Naval Hospital Camp Pendleton
Box 555191 Mercy Circle
Camp Pendleton, CA 92055-5191
Phone (760) 719-4747
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 |
|---|---|---|---|
| DS042748 | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1194358747",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "NAVAL HOSPITAL CAMP PENDLETON",
"address_2": "BOX 555191 MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "920555191",
"telephone_number": "760-719-4747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NAVAL HOSPITAL CAMP PENDLETON",
"address_2": "MERCY CIRCLE",
"city": "CAMP PENDLETON",
"state": "CA",
"postal_code": "920555191",
"telephone_number": "570-490-2400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIDUNAS",
"first_name": "ALEXANDER",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-21",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS042748",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camp Pendleton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.