Individual provider Active NPI

Vincent Joseph Porcaro II, DDS

  • Dentist
  • Lake Isabella, CA
National Provider Identifier
1548372550
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30707 Issued in CA
Practice address
5120 Lake Isabella Blvd
Lake Isabella, CA 93240-3848
Phone
(760) 379-5911
Fax
(760) 379-8888
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30707 CA Primary

Addresses

Primary practice location

5120 Lake Isabella Blvd
Lake Isabella, CA 93240-3848

Mailing address

5120 Lake Isabella Blvd
Post Office Box 3848
Lake Isabella, CA 93240
Phone (760) 379-5911

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

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548372550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 LAKE ISABELLA BLVD",
            "address_2": "POST OFFICE BOX 3848",
            "city": "LAKE ISABELLA",
            "state": "CA",
            "postal_code": "93240",
            "telephone_number": "760-379-5911",
            "fax_number": "760-379-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 LAKE ISABELLA BLVD",
            "city": "LAKE ISABELLA",
            "state": "CA",
            "postal_code": "932403848",
            "telephone_number": "760-379-5911",
            "fax_number": "760-379-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORCARO",
        "first_name": "VINCENT",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "30707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Isabella, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.