Individual provider Active NPI

Anca M Vladescu, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1215175013
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55682 Issued in CA
Practice address
6501 Crown Blvd Ste 102
San Jose, CA 95120-2903
Phone
(408) 268-5531
Fax
(408) 268-3464
NPI assigned
Feb 2, 2009
Last updated
Feb 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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 55682 CA Primary

Addresses

Primary practice location

6501 Crown Blvd Ste 102
San Jose, CA 95120-2903

Mailing address

6501 Crown Blvd Ste 102
San Jose, CA 95120-2903
Phone (408) 268-5531

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
I20160511001062 CA Order and Referring Only - DentistPractitioner - Dentist 9234428434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
55682CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1233532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1215175013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CROWN BLVD STE 102",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202903",
            "telephone_number": "408-268-5531",
            "fax_number": "408-268-3464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6501 CROWN BLVD STE 102",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951202903",
            "telephone_number": "408-268-5531",
            "fax_number": "408-268-3464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VLADESCU",
        "first_name": "ANCA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-02",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.