Individual provider Active NPI

Charles Salvatore Di Bari, D.D.S.

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1265677116
Registry record updated Dec 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
20097 Issued in CA
Practice address
2503 E Hatch Rd
Modesto, CA 95351-4817
Phone
(209) 537-5783
Fax
(209) 537-0443
NPI assigned
Dec 6, 2008
Last updated
Dec 6, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 6, 2008

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 20097 CA Primary

Addresses

Primary practice location

2503 E Hatch Rd
Modesto, CA 95351-4817

Mailing address

2503 E Hatch Rd
Modesto, CA 95351-4817
Phone (209) 537-5783

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

LicenseStateTypeSpecialty
20097CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rubencillo H Santos DDS Inc General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1228521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228521600000",
    "number": "1265677116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2503 E HATCH RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514817",
            "telephone_number": "209-537-5783",
            "fax_number": "209-537-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2503 E HATCH RD",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953514817",
            "telephone_number": "209-537-5783",
            "fax_number": "209-537-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DI BARI",
        "first_name": "CHARLES",
        "middle_name": "SALVATORE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-06",
        "last_updated": "2008-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "20097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2008; 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.