Active NPI
Michael Skidmore, DMD
- General Practice Dentistry
- Temecula, CA
National Provider Identifier
1528259678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 56532
- Practice address
- 27699 Jefferson Ave
306
Temecula, CA 92590-2661 - Phone
- (951) 506-2424
- Fax
- (951) 506-0604
- NPI assigned
- Aug 5, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D7334 | AZ | |
| General Practice Dentistry | 1223G0001X | 56532 | CA | Primary |
Addresses
Primary practice location
27699 Jefferson Ave
306
Temecula, CA 92590-2661
Mailing address
27699 Jefferson Ave
306
Temecula, CA 92590-2661
Phone (951) 506-2424
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 |
|---|---|---|---|
| D7334 | AZ | MD | General Practice Dentistry |
| 56532 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Apnea Solutions Inc | Current | Accepting new patients |
Locations
27699 Jefferson Ave
Ste 306
Temecula, CA 92590
Phone (951) 506-2424
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231977600000",
"number": "1528259678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE",
"address_2": "306",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902661",
"telephone_number": "951-506-2424",
"fax_number": "951-506-0604"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27699 JEFFERSON AVE",
"address_2": "306",
"city": "TEMECULA",
"state": "CA",
"postal_code": "925902661",
"telephone_number": "951-506-2424",
"fax_number": "951-506-0604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKIDMORE",
"first_name": "MICHAEL",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2009-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D7334",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "56532",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Temecula, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.