Active NPI
Noel Santos Miranda, DMD
- Dentist
- So. San Francisco, CA
National Provider Identifier
1366655235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 41283
- Practice address
- 1486 Huntington Avenue
Suite 302
So San Francisco, CA 94080-5971 - Phone
- (650) 583-8822
- Fax
- (650) 583-7940
- NPI assigned
- May 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 41283 | CA | Primary |
Addresses
Primary practice location
1486 Huntington Avenue
Suite 302
So San Francisco, CA 94080-5971
Mailing address
1486 Huntington Avenue
Suite 302
So San Francisco, CA 94080-5971
Phone (650) 583-8822
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 520109 | Other | CA | DENTICAL |
| B4128304 | Other | CA | DELTA OF CA STATE GOVERNM |
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 |
|---|---|---|---|
| 41283 | CA | MD | Licensed Psychiatric Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noel S. Miranda, DMD Inc. | Dentist | 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 and National Provider Directory roles.
-
- Dentist
- South San Francisco, CA
- NPI 1174996516
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1481673600000",
"number": "1366655235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1486 HUNTINGTON AVENUE",
"address_2": "SUITE 302",
"city": "SO SAN FRANCISCO",
"state": "CA",
"postal_code": "940805971",
"telephone_number": "650-583-8822",
"fax_number": "650-583-7940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1486 HUNTINGTON AVENUE",
"address_2": "SUITE 302",
"city": "SO SAN FRANCISCO",
"state": "CA",
"postal_code": "940805971",
"telephone_number": "650-583-8822",
"fax_number": "650-583-7940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "NOEL",
"middle_name": "SANTOS",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-08",
"last_updated": "2016-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "41283",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "520109",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DELTA OF CA STATE GOVERNM",
"identifier": "B4128304",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in So. San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.