Individual provider Active NPI

Susana Verbis, D.M.D.

  • General Practice Dentistry
  • Benicia, CA
National Provider Identifier
1487891875
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57820 Issued in CA
Practice address
717 Larkspur CT
Benicia, CA 94510-3836
Phone
(707) 373-1992
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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 57820 CA Primary

Addresses

Primary practice location

717 Larkspur CT
Benicia, CA 94510-3836

Mailing address

717 Larkspur CT
Benicia, CA 94510-3836
Phone (707) 373-1992

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

LicenseStateTypeSpecialty
57820CAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1487891875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 LARKSPUR CT",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103836",
            "telephone_number": "707-373-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 LARKSPUR CT",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103836",
            "telephone_number": "707-373-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERBIS",
        "first_name": "SUSANA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benicia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; 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.