Roderick Fajardo Pangilinan

Primary specialty

DentistTaxonomy code 122300000X

License

54295 Issued in CA

Practice address

4123 University Ave
San Diego, CA 92105-1418

Phone

(619) 521-0033

Fax

(619) 521-0961

NPI assigned

Nov 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rpangilinan@direct.westerndental.com

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.

• Roderick Pangilinan Dental Corporation

  • Dental Clinic/Center
  • El Centro, CA
  • NPI 1922861400
  NPD Authorized official
• Western Dental Services, Inc.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1841354347
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1386711901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711314",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920721314",
            "telephone_number": "619-677-0598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4123 UNIVERSITY AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051418",
            "telephone_number": "619-521-0033",
            "fax_number": "619-521-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGILINAN",
        "first_name": "RODERICK",
        "middle_name": "FAJARDO",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Panganiban Marriage and Family Therapy Inc.
• Kimberly Dirks Panganiban, LMFT
• Maia Jisel Pangelinan
• Edgardo Alfaro Pangilinan, CRT,RRT(R)
• Nilda Magpili Pangilinan
• Monique Shydell Paniagua
• Justine Ann Panian, M.D.
• Christine Pankow
• Arlene Pantig Panlaqui, RN
• Pia S. Pannaraj, M.D., M.P.H.

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; 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.