Individual provider Active NPI

Sabrina Noelle Cimerol, D.M.D

  • Dentist
  • Mammoth Lakes, CA
National Provider Identifier
1295268365
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN002776 Issued in PA
Practice address
664 Old Mammoth Rd
Mammoth Lakes, CA 93546-2048
Phone
(760) 934-8571
NPI assigned
Apr 6, 2017
Last updated
Jan 9, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN002776 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

664 Old Mammoth Rd
Mammoth Lakes, CA 93546-2048

Mailing address

664 Old Mammoth Road
PO Box 2357
Mammoth Lakes, CA 93546
Phone (760) 934-8571

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20170803001640 LA Order and Referring Only - DentistPractitioner - Dentist 8022389444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN002776PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ariel Dental LLC Dentist PastSince Aug 23, 2020 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": "1491436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1295268365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 OLD MAMMOTH ROAD",
            "address_2": "PO BOX 2357",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "93546",
            "telephone_number": "760-934-8571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 OLD MAMMOTH RD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935462048",
            "telephone_number": "760-934-8571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CIMEROL",
        "first_name": "SABRINA",
        "middle_name": "NOELLE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-06",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DN002776",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mammoth Lakes, CA

Sources for this page

Verify at the official NPI Registry.