NPIMap

Organization Active NPI

Virgnia Padua Mattson D.M.D.

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1235768631
Registry record updated Apr 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
VIRGNIA PADUA MATTSON D.M.D.
Practice address
11717 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2419
Phone
(858) 673-1633
NPI assigned
Apr 7, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2020

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

Authorized official

Name
Dr. Virginia Mattson, DMDNPI 1528125325
Title
Owner
Phone
(858) 673-1633

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

11717 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2419

Mailing address

11717 Bernardo Plaza CT Ste 100
San Diego, CA 92128-2419
Phone (858) 673-1633

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586217600000",
    "number": "1235768631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11717 BERNARDO PLAZA CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282419",
            "telephone_number": "858-673-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11717 BERNARDO PLAZA CT STE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282419",
            "telephone_number": "858-673-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIRGNIA PADUA MATTSON D.M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-07",
        "last_updated": "2020-04-07",
        "certification_date": "2020-04-07",
        "status": "A",
        "authorized_official_last_name": "MATTSON",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-673-1633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.

Verify at the official NPI Registry.