Active NPI
Nicole Bartolome, DDS
- Pediatric Dentistry
- San Francisco, CA
National Provider Identifier
1255729190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 64289
- Practice address
- 707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210 - Phone
- (415) 514-1181
- NPI assigned
- Dec 30, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 64289 | CA | Primary |
Addresses
Primary practice location
707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210
Mailing address
707 Parnassus Ave
Box 0753
San Francisco, CA 94143-2210
Phone (415) 514-1181
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 |
|---|---|---|---|
| 64289 | CA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| UCSF Pediatric Dentistry | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Dentistry
- San Francisco, CA
- NPI 1619041365
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1419897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1419897600000",
"number": "1255729190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 PARNASSUS AVE",
"address_2": "BOX 0753",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432210",
"telephone_number": "415-514-1181"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 PARNASSUS AVE",
"address_2": "BOX 0753",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432210",
"telephone_number": "415-514-1181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BARTOLOME",
"first_name": "NICOLE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-30",
"last_updated": "2014-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "64289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.