Joseph Antypas, DDS

Individual provider Active NPI General Practice Dentistry · Riverbank, CA

NPI 1487786356 · NPPES record last updated Jun 18, 2013

Key facts

NPI
1487786356
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
B40525 (CA)
Practice address
3324 Santa Fe St Ste B
Riverbank, CA 95367-2317
Phone
(209) 869-1558
Fax
(209) 869-1560
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
B40525CAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X B40525 CA Yes

Addresses

Primary practice location

3324 Santa Fe St Ste B
Riverbank, CA 95367-2317

Mailing address

3324 Santa Fe St Ste B
Riverbank, CA 95367-2317
Phone (209) 869-1558

Other providers in Riverbank, CA

All providers in Riverbank, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.