Active NPI
Jason S Bishop, DDS
- Pediatric Dentistry
- Mammoth Lakes, CA
National Provider Identifier
1508935602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 43758
- Practice address
- 85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073 - Phone
- (760) 924-4007
- Fax
- (760) 924-4048
- NPI assigned
- Nov 6, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 43758 | CA | Primary |
Addresses
Primary practice location
85 Sierra Park Rd
Mammoth Lakes, CA 93546-2073
Mailing address
1680 N Coast Highway 101 Unit 47
Encinitas, CA 92024-1050
Phone (760) 710-1369
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 |
|---|---|---|---|
| 43758 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466035200000",
"number": "1508935602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 N COAST HIGHWAY 101 UNIT 47",
"city": "ENCINITAS",
"state": "CA",
"postal_code": "920241050",
"telephone_number": "760-710-1369"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 SIERRA PARK RD",
"city": "MAMMOTH LAKES",
"state": "CA",
"postal_code": "935462073",
"telephone_number": "760-924-4007",
"fax_number": "760-924-4048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BISHOP",
"first_name": "JASON",
"middle_name": "S",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-06",
"last_updated": "2016-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "43758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mammoth Lakes, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.