Active NPI
Michael Joseph Raffo, D.M.D
- Dentist
- Capitola, CA
National Provider Identifier
1386712297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54933
- Practice address
- 2001 40TH Ave Ste G
Capitola, CA 95010-2536 - Phone
- (831) 476-8700
- Fax
- (831) 465-7600
- NPI assigned
- Nov 30, 2006
- 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 | 54933 | CA | Primary |
Addresses
Primary practice location
2001 40TH Ave Ste G
Capitola, CA 95010-2536
Mailing address
14 Sunset Ter
Scotts Valley, CA 95066-3818
Phone (831) 600-3261
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 |
|---|---|---|---|
| 54933 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1191196800000",
"number": "1386712297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 SUNSET TER",
"city": "SCOTTS VALLEY",
"state": "CA",
"postal_code": "950663818",
"telephone_number": "831-600-3261",
"fax_number": "831-466-9483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 40TH AVE STE G",
"city": "CAPITOLA",
"state": "CA",
"postal_code": "950102536",
"telephone_number": "831-476-8700",
"fax_number": "831-465-7600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAFFO",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-30",
"last_updated": "2007-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "54933",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Capitola, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.