Individual provider Active NPI

Kaitlyn Joy Neglerio, D.M.D

  • Dentist
  • San Diego, CA
National Provider Identifier
1376070136
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
106304 Issued in CA
Practice address
13295 Black Mountain Rd Ste 3
San Diego, CA 92129-2686
Phone
(858) 442-8909
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 060964 NY
Dentist 122300000X 106304 CA Primary

Addresses

Primary practice location

13295 Black Mountain Rd Ste 3
San Diego, CA 92129-2686

Mailing address

9420 Maler Rd
San Diego, CA 92129-3816
Phone (858) 538-1298

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
106304CAMDMarriage & Family Therapist
060964NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Neglerio Dental Corporation CurrentSince Mar 31, 2024 Accepting new patients
Neglerio Dental Group Inc PastSince Mar 31, 2024 Accepting new patients

Locations

13295 Black Mountain Rd
Ste 3
San Diego, CA 92129
Phone (858) 442-8909

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1376070136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9420 MALER RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921293816",
            "telephone_number": "858-538-1298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13295 BLACK MOUNTAIN RD STE 3",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921292686",
            "telephone_number": "858-442-8909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEGLERIO",
        "first_name": "KAITLYN",
        "middle_name": "JOY",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "060964",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.