NPIMap

Organization Active NPI

Editha M. Aquino D.M.D. Professional Dental Corporation

  • General Practice Dentistry
  • Vallejo, CA
National Provider Identifier
1265799753
Registry record updated Apr 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EDITHA M. AQUINO D.M.D. PROFESSIONAL DENTAL CORPORATION
Practice address
2600 Springs Rd
Vallejo, CA 94591-5713
Phone
(707) 642-3711
Fax
(707) 556-9237
NPI assigned
Apr 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2012

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

Authorized official

Name
Editha Mendoza Aquino, D.M.D.NPI 1780666115
Title
Director
Phone
(707) 642-3711

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

2600 Springs Rd
Vallejo, CA 94591-5713

Mailing address

2600 Springs Rd
Vallejo, CA 94591-5713
Phone (707) 642-3711

National Provider Directory

National Provider Directory

Locations

2600 Springs Rd
Vallejo, CA 94591
Phone (707) 642-3711

Practitioners & affiliated clinicians

Practitioners 4

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": "1334880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334880000000",
    "number": "1265799753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 SPRINGS RD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915713",
            "telephone_number": "707-642-3711",
            "fax_number": "707-556-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SPRINGS RD",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945915713",
            "telephone_number": "707-642-3711",
            "fax_number": "707-556-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDITHA M. AQUINO D.M.D. PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-20",
        "last_updated": "2012-04-20",
        "status": "A",
        "authorized_official_last_name": "AQUINO",
        "authorized_official_first_name": "EDITHA",
        "authorized_official_middle_name": "MENDOZA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "707-642-3711",
        "authorized_official_credential": "D.M.D."
    },
    "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 Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; 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.