Edegar Vergara, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

63272 Issued in CA

Practice address

2340 McKee Rd Ste 3
San Jose, CA 95116-1615

Phone

(669) 284-9988

NPI assigned

Mar 3, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Edegar Vergara, DMD Inc

  • Dental Clinic/Center
  • San Jose, CA
  • NPI 1699262634
  NPD (past) Authorized official

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523836800000",
    "number": "1326463126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 CAPITAN DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945365447",
            "telephone_number": "510-585-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 MCKEE RD STE 3",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161615",
            "telephone_number": "669-284-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGARA",
        "first_name": "EDEGAR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-03",
        "last_updated": "2018-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-024422",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayra Vera
• Mae-Richelle Ragasa Verano, MSW
• Giovanna Verdin Lopez
• Uriel Verduzco Aleman Jr.
• Alejandra Inez Vergara, LCSW
• Eduardo Vergara Sr., MD
• Nilda Vergara, M.D.
• Vericare of California Medical Group
• Verity Billing Solutions LLC
• Verity Medical Foundation

• Dentist in San Jose, CA
• Providers in San Jose, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2018; 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.

Verify at the official NPI Registry.