Individual provider Active NPI

Jorge C De la Osa, DDS

  • Dentist
  • Sacramento, CA
National Provider Identifier
1336186618
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54134 Issued in CA
Practice address
7315 Stockton Blvd
Suite # 3
Sacramento, CA 95823-2731
Phone
(916) 422-8332
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54134 CA Primary

Addresses

Primary practice location

7315 Stockton Blvd
Suite # 3
Sacramento, CA 95823-2731

Mailing address

4126 Sea Meadow Way
Sacramento, CA 95823-6310
Phone (786) 253-4599

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
I20240117003787 CA Order and Referring Only - DentistPractitioner - Dentist 6709238538

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54134CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
De la Osa Dental Group,Inc. Current Accepting new patients
Orlome Dental Group Inc Current Accepting new patients

Organizations & group practices 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1336186618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4126 SEA MEADOW WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958236310",
            "telephone_number": "786-253-4599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 STOCKTON BLVD",
            "address_2": "SUITE # 3",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958232731",
            "telephone_number": "916-422-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA OSA",
        "first_name": "JORGE",
        "middle_name": "C",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.