Active NPI
Evelyn Escobedo, DDS
- Dentist
- Santa Rosa, CA
National Provider Identifier
1487127486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 103409
- Practice address
- 2335 Summercreek Dr Apt 59
Santa Rosa, CA 95404-7761 - Phone
- (415) 910-9796
- NPI assigned
- Jan 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 103409 | CA | Primary |
Addresses
Primary practice location
2335 Summercreek Dr Apt 59
Santa Rosa, CA 95404-7761
Mailing address
2335 Summercreek Dr Apt 59
Santa Rosa, CA 95404-7761
Phone (415) 910-9796
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 103409 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1546387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546387200000",
"number": "1487127486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2335 SUMMERCREEK DR APT 59",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954047761",
"telephone_number": "415-910-9796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2335 SUMMERCREEK DR APT 59",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954047761",
"telephone_number": "415-910-9796"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESCOBEDO",
"first_name": "EVELYN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-01-02",
"last_updated": "2019-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.