Individual provider Active NPI

Johnah Galicia

  • Endodontics
  • San Francisco, CA
National Provider Identifier
1508261512
Registry record updated Oct 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
SP 272 Issued in CA
Practice address
155 5TH St Ste 2F
San Francisco, CA 94103-2919
Phone
(415) 929-6524
NPI assigned
Nov 3, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X SP 272 CA Primary

Addresses

Primary practice location

155 5TH St Ste 2F
San Francisco, CA 94103-2919

Mailing address

60 Crestwood Dr Apt 1
Daly City, CA 94015-3277

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
I20200110000390 CA Order and Referring Only - DentistPractitioner - Dentist 5597190009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP 272CAMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
University of the Pacific Arthur a. Dugoni School of Dentistry PastSince Jul 9, 2023 Accepting new patients
University of the Pacific Arthur a. Dugoni School of Dentistry Past Accepting new patients

Organizations & group practices 2

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": "1414972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1508261512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CRESTWOOD DR APT 1",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940153277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 5TH ST STE 2F",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032919",
            "telephone_number": "415-929-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALICIA",
        "first_name": "JOHNAH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-03",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "SP 272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.