Active NPI
Edwin Josephs, DDS
- General Practice Dentistry
- Modesto, CA
National Provider Identifier
1437201449
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 55370
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160511001040 | CA | Order and Referring Only - Oral Surgery | 0244529444 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New 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.
-
- General Practice Dentistry
- Modesto, CA
- NPI 1548646839
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.