NPIMap

Organization Active NPI

Nieva Socorro R. Bautista D.M.D., Inc

  • Preferred Provider Organization
  • Vista, CA
National Provider Identifier
1194932152
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
47229 Issued in CA
Legal business name
NIEVA SOCORRO R. BAUTISTA D.M.D., INC
Practice address
1293 E Vista Way
Vista, CA 92084-4039
Phone
(760) 724-7645
Fax
(760) 724-7640
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Nieva R. BautistaNPI 1013084532
Title
Ceo/Owner
Phone
(760) 724-7645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 47229 CA Primary

Addresses

Primary practice location

1293 E Vista Way
Vista, CA 92084-4039

Mailing address

1293 E Vista Way
Vista, CA 92084-4039
Phone (760) 724-7645

Other names 1

  • Vista Foothill Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1293 E Vista Way
Vista, CA 92084
Phone (760) 724-7645

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1194932152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1293 E VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920844039",
            "telephone_number": "760-724-7645",
            "fax_number": "760-724-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1293 E VISTA WAY",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920844039",
            "telephone_number": "760-724-7645",
            "fax_number": "760-724-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEVA SOCORRO R. BAUTISTA D.M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "NIEVA",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "760-724-7645"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "47229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Foothill Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.