Individual provider Active NPI

James Redford, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • San Marcos, CA
National Provider Identifier
1376959536
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
63658 Issued in CA
Practice address
709 Center Dr Ste 101
San Marcos, CA 92069-2502
Phone
(760) 746-2045
NPI assigned
Jul 9, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0442000166 VA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 63658 CA Primary

Addresses

Primary practice location

709 Center Dr Ste 101
San Marcos, CA 92069-2502

Mailing address

709 Center Dr Ste 101
San Marcos, CA 92069-2502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170109001167 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0840571725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0442000166VAMDDentist
63658CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Nosti and Reagan Dental Corporation 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.

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1376959536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 CENTER DR STE 101",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 CENTER DR STE 101",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692502",
            "telephone_number": "760-746-2045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDFORD",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-09",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0442000166",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "63658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.