Individual provider Active NPI

Ilana Vaynshteyn

  • General Practice Dentistry
  • Santa Cruz, CA
National Provider Identifier
1275901050
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
65005 Issued in CA
Practice address
1830 Commercial Way
Santa Cruz, CA 95065-1819
Phone
(831) 464-5409
NPI assigned
Sep 9, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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 65005 CA Primary

Addresses

Primary practice location

1830 Commercial Way
Santa Cruz, CA 95065-1819

Mailing address

1830 Commercial Way
Santa Cruz, CA 95065-1819
Phone (831) 464-5409

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
I20160405002024 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 7113225202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dientes Community Dental Care. PastSince Dec 15, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1275901050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1830 COMMERCIAL WAY",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950651819",
            "telephone_number": "831-464-5409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAYNSHTEYN",
        "first_name": "ILANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-09",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "65005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Cruz, CA

Sources for this page

Verify at the official NPI Registry.