Active NPI
Raymond Nepomuceno, DDS
- Dentist
- Modesto, CA
National Provider Identifier
1326326281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 48648
- Practice address
- 2020 Coffee Rd
Suite B-4
Modesto, CA 95355-2427 - Phone
- (209) 529-5886
- NPI assigned
- Jul 26, 2011
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 48648 | CA | Primary |
Addresses
Primary practice location
2020 Coffee Rd
Suite B-4
Modesto, CA 95355-2427
Mailing address
2020 Coffee Rd
Suite B-4
Modesto, CA 95355-2427
Phone (209) 529-5886
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ray Nepomuceno DDS Inc | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Modesto, CA
- NPI 1376613885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450310400000",
"number": "1326326281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2020 COFFEE RD",
"address_2": "SUITE B-4",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552427",
"telephone_number": "209-529-5886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 COFFEE RD",
"address_2": "SUITE B-4",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552427",
"telephone_number": "209-529-5886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEPOMUCENO",
"first_name": "RAYMOND",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-07-26",
"last_updated": "2015-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "48648",
"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 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.