Individual provider Active NPI

Steven Fronczak, DMD

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1528638236
Registry record updated Jun 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106324 Issued in CA
Practice address
1455 G St
San Diego, CA 92101-7434
Phone
(619) 324-4981
NPI assigned
Jun 26, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2021

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 106324 CA Primary

Addresses

Primary practice location

1455 G St
San Diego, CA 92101-7434

Mailing address

15816 Cumberland Dr
Poway, CA 92064-2345
Phone (858) 602-2968

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
106324CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Minh Pham and Diana DO Dental Corporation PastSince Jul 4, 2021 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1624665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624665600000",
    "number": "1528638236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15816 CUMBERLAND DR",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642345",
            "telephone_number": "858-602-2968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 G ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017434",
            "telephone_number": "619-324-4981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRONCZAK",
        "first_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-26",
        "last_updated": "2021-06-26",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2021; 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.