Active NPI
Isaiah John Rabata, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1265275457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 6001575-15
- Practice address
- 2310 Craven St BLDG 3230
San Diego, CA 92136-5596 - Phone
- (619) 556-8240
- NPI assigned
- Jun 14, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 6001575-15 | WI | Primary |
Addresses
Primary practice location
2310 Craven St BLDG 3230
San Diego, CA 92136-5596
Mailing address
N7620 N Crystal Lake Rd
Beaver Dam, WI 53916-9453
Phone (920) 318-0585
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 |
|---|---|---|---|
| 6001575-15 | WI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718323200000",
"number": "1265275457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N7620 N CRYSTAL LAKE RD",
"city": "BEAVER DAM",
"state": "WI",
"postal_code": "539169453",
"telephone_number": "920-318-0585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 CRAVEN ST BLDG 3230",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921365596",
"telephone_number": "619-556-8240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RABATA",
"first_name": "ISAIAH",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-06-14",
"last_updated": "2024-06-14",
"certification_date": "2024-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "WI",
"license": "6001575-15",
"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 Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.