Individual provider Active NPI

Edwin Josephs, DDS

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1437201449
Registry record updated Aug 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55370 Issued in CA
Practice address
1213 Coffee Rd
Ste. J
Modesto, CA 95355-4229
Phone
(209) 529-6995
Fax
(209) 529-1810
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 55370 CA Primary

Addresses

Primary practice location

1213 Coffee Rd
Ste. J
Modesto, CA 95355-4229

Mailing address

5657 Suttermill Dr
Riverbank, CA 95367-9590
Phone (213) 820-2153

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
I20160511001040 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0244529444

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edwin Y. Josephs DDS, Inc General Practice 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": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1437201449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5657 SUTTERMILL DR",
            "city": "RIVERBANK",
            "state": "CA",
            "postal_code": "953679590",
            "telephone_number": "213-820-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 COFFEE RD",
            "address_2": "STE. J",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554229",
            "telephone_number": "209-529-6995",
            "fax_number": "209-529-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPHS",
        "first_name": "EDWIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.