Individual provider Active NPI

Carmela Mujar Ambrosio, DMD

  • General Practice Dentistry
  • Lemon Grove, CA
National Provider Identifier
1265501043
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50721 Issued in CA
Practice address
7967 Broadway
Lemon Grove, CA 91945-1809
Phone
(619) 741-3045
NPI assigned
Nov 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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 50721 CA Primary

Addresses

Primary practice location

7967 Broadway
Lemon Grove, CA 91945-1809

Mailing address

7967 Broadway
Lemon Grove, CA 91945-1809
Phone (619) 741-3045

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
I20160226000551 CA Order and Referring Only - DentistPractitioner - Dentist 6608171723

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1265501043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7967 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451809",
            "telephone_number": "619-741-3045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7967 BROADWAY",
            "city": "LEMON GROVE",
            "state": "CA",
            "postal_code": "919451809",
            "telephone_number": "619-741-3045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMBROSIO",
        "first_name": "CARMELA",
        "middle_name": "MUJAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemon Grove, CA

Sources for this page

Verify at the official NPI Registry.