Individual provider Active NPI

Scott A. Tangeman, D.D.S.

  • General Practice Dentistry
  • Bakersfield, CA
National Provider Identifier
1366750655
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
031870 Issued in CA
Practice address
5500 Ming Ave
Suite 165
Bakersfield, CA 93309-4689
Phone
(661) 835-8785
NPI assigned
Sep 20, 2010
Reactivated
Sep 11, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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 031870 CA Primary

Addresses

Primary practice location

5500 Ming Ave
Suite 165
Bakersfield, CA 93309-4689

Mailing address

5500 Ming Ave
Suite 165
Bakersfield, CA 93309-4689
Phone (661) 835-8785

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
031870CAMDGeneral Practice Dentistry

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": "1284940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1366750655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MING AVE",
            "address_2": "SUITE 165",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094689",
            "telephone_number": "661-835-8785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MING AVE",
            "address_2": "SUITE 165",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933094689",
            "telephone_number": "661-835-8785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGEMAN",
        "first_name": "SCOTT",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-20",
        "last_updated": "2013-09-11",
        "deactivation_date": "2010-09-28",
        "reactivation_date": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "031870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.