Active NPI
Nicolas Patino, DDS
- General Practice Dentistry
- El Monte, CA
National Provider Identifier
1336298959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 42692
- Practice address
- 11733 Valley Blvd
El Monte, CA 91732-3073 - Phone
- (626) 575-7565
- Fax
- (626) 575-0240
- NPI assigned
- Jan 10, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 42692 | CA | Primary |
Addresses
Primary practice location
11733 Valley Blvd
El Monte, CA 91732-3073
Mailing address
904 N Wemar Way
Montebello, CA 90640-2640
Phone (323) 869-9896
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42692 | Other | CA | LICENSE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 42692 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alfonso E. Martinez D.D.S. a Professional Corporation | General Practice | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Corporation
- General Practice Dentistry
- El Monte, CA
- NPI 1457572166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336298959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 N WEMAR WAY",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906402640",
"telephone_number": "323-869-9896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11733 VALLEY BLVD",
"city": "EL MONTE",
"state": "CA",
"postal_code": "917323073",
"telephone_number": "626-575-7565",
"fax_number": "626-575-0240"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATINO",
"first_name": "NICOLAS",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "42692",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "42692",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Monte, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.