Abraham Navarro Medina, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

4147640 Issued in ZZ

Practice address

Calle Emiliano Zapata #173
Zona Centro
Tujuana, CA 22000

Phone

(011) 526-6468

NPI assigned

Nov 30, 2015

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 30, 2015.

{
    "created_epoch": "1448841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1427422575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4364 BONITA RD",
            "address_2": "#233",
            "city": "BONITA",
            "state": "CA",
            "postal_code": "919021421",
            "telephone_number": "011-526-6468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CALLE EMILIANO ZAPATA #173",
            "address_2": "ZONA CENTRO",
            "city": "TUJUANA",
            "state": "CA",
            "postal_code": "22000",
            "telephone_number": "011-526-6468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAVARRO MEDINA",
        "first_name": "ABRAHAM",
        "name_prefix": "Mr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-30",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ZZ",
            "license": "4147640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.