NPIMap

Individual provider Active NPI

Ronald Francis Antimarino, DMD

  • Dentist
  • Long Beach, CA
National Provider Identifier
1396809018
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
27949 Issued in CA
Practice address
3816 Woodruff Avenue
Suite 310
Long Beach, CA 90808-2146
Phone
(562) 421-9304
Fax
(562) 421-2363
NPI assigned
Dec 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 27949 CA Primary

Addresses

Primary practice location

3816 Woodruff Avenue
Suite 310
Long Beach, CA 90808-2146

Mailing address

3816 Woodruff Avenue
Suite 310
Long Beach, CA 90808-2146
Phone (562) 421-9304

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27949CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald F Antimarino DMD Inc Dentist Past Accepting new patients
Sheryl a. Kam DDS & Curtis P. Kam DDS PTRS Past Accepting new patients

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": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396809018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVENUE",
            "address_2": "SUITE 310",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082146",
            "telephone_number": "562-421-9304",
            "fax_number": "562-421-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3816 WOODRUFF AVENUE",
            "address_2": "SUITE 310",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908082146",
            "telephone_number": "562-421-9304",
            "fax_number": "562-421-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTIMARINO",
        "first_name": "RONALD",
        "middle_name": "FRANCIS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "27949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.