Individual provider Active NPI

Charles U Basso, DDS

  • General Practice Dentistry
  • Escondido, CA
National Provider Identifier
1336139963
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46240 Issued in CA
Practice address
457 E Grand Ave
Suite 4
Escondido, CA 92025-3353
Phone
(760) 747-7878
Fax
(760) 747-2156
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 46240 CA Primary

Addresses

Primary practice location

457 E Grand Ave
Suite 4
Escondido, CA 92025-3353

Mailing address

457 E Grand Ave
Suite 4
Escondido, CA 92025-3353
Phone (760) 747-7878

Other identifiers 1

IdentifierTypeStateIssuer
42640OtherCASTATE LICENSE #

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
I20210923002809 CA Practitioner - Oral Surgery 9931415841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charles U. Basso DDS Inc General Practice CurrentSince Mar 1, 2020 Accepting new patients

Locations

457 E Grand Ave
Ste 4
Escondido, CA 92025
Phone (760) 747-7878

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": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1336139963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 E GRAND AVE",
            "address_2": "SUITE 4",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253353",
            "telephone_number": "760-747-7878",
            "fax_number": "760-747-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 E GRAND AVE",
            "address_2": "SUITE 4",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920253353",
            "telephone_number": "760-747-7878",
            "fax_number": "760-747-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSO",
        "first_name": "CHARLES",
        "middle_name": "U",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46240",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "42640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

Verify at the official NPI Registry.