Justin Sycamore DDS

Primary specialty

DentistTaxonomy code 122300000X

License

59913 Issued in CA

Legal business name

JUSTIN SYCAMORE DDS

Practice address

777 E Thousand Oaks Blvd
Thousand Oaks, CA 91360-6054

Phone

(805) 777-0050

Fax

(805) 777-0040

NPI assigned

Oct 3, 2014

Last updated

Oct 3, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Justin Sycamore, DDSNPI 1285833442

Title

Dentist

Phone

(805) 777-0050

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Justin Sycamore, DDS

  • Dentist
  • Thousand Oaks, CA
  • NPI 1285833442
  NPD (past) Authorized official

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1346643319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 E THOUSAND OAKS BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606054",
            "telephone_number": "805-777-0050",
            "fax_number": "805-777-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E THOUSAND OAKS BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913606054",
            "telephone_number": "805-777-0050",
            "fax_number": "805-777-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN SYCAMORE DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "SYCAMORE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "805-777-0050",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.