Individual provider Active NPI

Portia Dela Vega Oblea, DMD

  • Dentist
  • San Jose, CA
National Provider Identifier
1366645236
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50963 Issued in CA
Practice address
2356 Senter Rd
San Jose, CA 95112-2615
Phone
(408) 993-9939
Fax
(408) 993-9363
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50963 CA Primary

Addresses

Primary practice location

2356 Senter Rd
San Jose, CA 95112-2615

Mailing address

2356 Senter Rd
San Jose, CA 95112-2615
Phone (408) 993-9939

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

LicenseStateTypeSpecialty
50963CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Canyon Ranch Dental Care Inc. Dentist Current Accepting new patients
Portia Dela Vega Oblea,DMD,Inc Past Accepting new patients

Organizations & group practices 2

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1366645236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2356 SENTER RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951122615",
            "telephone_number": "408-993-9939",
            "fax_number": "408-993-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2356 SENTER RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951122615",
            "telephone_number": "408-993-9939",
            "fax_number": "408-993-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBLEA",
        "first_name": "PORTIA",
        "middle_name": "DELA VEGA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.