Individual provider Active NPI

Rafael Ramirez Valdes, DDS

  • Dentist
  • San Pablo, CA
National Provider Identifier
1396191920
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100174 Issued in CA
Practice address
2232 Road 20
San Pablo, CA 94806-3318
Phone
(510) 236-5640
NPI assigned
May 12, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100174 CA Primary

Addresses

Primary practice location

2232 Road 20
San Pablo, CA 94806-3318

Mailing address

1945 Berkeley Way Apt 318
Berkeley, CA 94704-3258
Phone (415) 672-0093

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
I20160910000283 CA Order and Referring Only - DentistPractitioner - Dentist 3476849837

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Macias and Crespo 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": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1396191920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1945 BERKELEY WAY APT 318",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947043258",
            "telephone_number": "415-672-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 ROAD 20",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063318",
            "telephone_number": "510-236-5640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMIREZ VALDES",
        "first_name": "RAFAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pablo, CA

Sources for this page

Verify at the official NPI Registry.