Individual provider Active NPI

Nicasio Macaraeg Abriol Jr., D.M.D.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1336366418
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43301 Issued in CA
Practice address
3068 Story Rd
San Jose, CA 95127-3934
Phone
(408) 259-0458
Fax
(408) 729-0559
NPI assigned
Apr 19, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 43301 CA Primary

Addresses

Primary practice location

3068 Story Rd
San Jose, CA 95127-3934

Mailing address

3068 Story Rd
San Jose, CA 95127-3934
Phone (408) 259-0458

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
I20160307000308 CA Order and Referring Only - DentistPractitioner - Dentist 2365748043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Abriol Dental Corp. 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.

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336366418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3068 STORY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273934",
            "telephone_number": "408-259-0458",
            "fax_number": "408-729-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3068 STORY RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273934",
            "telephone_number": "408-259-0458",
            "fax_number": "408-729-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRIOL",
        "first_name": "NICASIO",
        "middle_name": "MACARAEG",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.