NPIMap

Organization Active NPI

Mencita Dabu Masangkay DMD Inc.

  • General Practice Dentistry
  • Hercules, CA
National Provider Identifier
1225588395
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
44028 Issued in CA
Legal business name
MENCITA DABU MASANGKAY DMD INC.
Doing business as
Smile Dental
Practice address
500 Alfred Nobel Dr
Suite 145
Hercules, CA 94547-1838
Phone
(510) 741-7788
Fax
(510) 741-7705
NPI assigned
Oct 12, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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

Authorized official

Name
Dr. Mencita Dabu Masangkay, DMD
Title
Owner
Phone
(510) 672-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 44028 CA Primary

Addresses

Primary practice location

500 Alfred Nobel Dr
Suite 145
Hercules, CA 94547-1838

Mailing address

500 Alfred Nobel Dr
Suite 145
Hercules, CA 94547-1838
Phone (510) 741-7788

Other names 1

  • Smile Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mencita Dabu Masangkay DMD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476230400000",
    "number": "1225588395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR",
            "address_2": "SUITE 145",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471838",
            "telephone_number": "510-741-7788",
            "fax_number": "510-741-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALFRED NOBEL DR",
            "address_2": "SUITE 145",
            "city": "HERCULES",
            "state": "CA",
            "postal_code": "945471838",
            "telephone_number": "510-741-7788",
            "fax_number": "510-741-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENCITA DABU MASANGKAY DMD INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A",
        "authorized_official_last_name": "MASANGKAY",
        "authorized_official_first_name": "MENCITA",
        "authorized_official_middle_name": "DABU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-672-1770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "44028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hercules, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.