Individual provider Active NPI

Jose F.S. Miranda, D.M.D.

  • General Practice Dentistry
  • Chino Hills, CA
National Provider Identifier
1538237953
Registry record updated Feb 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41482 Issued in CA
Practice address
14676 Pipeline Ave.
Ste. Q
Chino Hills, CA 91709-1909
Phone
(909) 393-3180
Fax
(909) 393-0372
NPI assigned
Dec 1, 2006
Last updated
Feb 25, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 25, 2015

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 41482 CA Primary

Addresses

Primary practice location

14676 Pipeline Ave.
Ste. Q
Chino Hills, CA 91709-1909

Mailing address

14676 Pipeline Ave Ste Q
Chino Hills, CA 91709-1918
Phone (909) 393-3180

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
I20150828002390 CA Order and Referring Only - DentistPractitioner - Dentist 5092021527

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
41482CAMDGeneral Practice Dentistry

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424822400000",
    "number": "1538237953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14676 PIPELINE AVE STE Q",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091918",
            "telephone_number": "909-393-3180",
            "fax_number": "909-393-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14676 PIPELINE AVE.",
            "address_2": "STE. Q",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917091909",
            "telephone_number": "909-393-3180",
            "fax_number": "909-393-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRANDA",
        "first_name": "JOSE",
        "middle_name": "F.S.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2015-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.