Active NPI
Robert Bruce Folk Jr., D.D.S., M.S.
- Endodontics
- San Diego, CA
National Provider Identifier
1326021643
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 53538
- Practice address
- 11777 Bernardo Plaza CT
Suite 209
San Diego, CA 92128-2405 - Phone
- (858) 487-1559
- NPI assigned
- Nov 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 53538 | CA | Primary |
Addresses
Primary practice location
11777 Bernardo Plaza CT
Suite 209
San Diego, CA 92128-2405
Mailing address
11777 Bernardo Plaza CT
Suite 209
San Diego, CA 92128-2405
Phone (858) 487-1559
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130611000331 | CA | Order and Referring Only - Oral Surgery | 8628217205 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53538 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326021643",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11777 BERNARDO PLAZA CT",
"address_2": "SUITE 209",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282405",
"telephone_number": "858-487-1559"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11777 BERNARDO PLAZA CT",
"address_2": "SUITE 209",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921282405",
"telephone_number": "858-487-1559"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLK",
"first_name": "ROBERT",
"middle_name": "BRUCE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "53538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.