David O Medina, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

57425 Issued in CA

Practice address

10925 Magnolia Ave
Riverside, CA 92505-3044

Phone

(951) 977-9991

Fax

(951) 588-8552

NPI assigned

Aug 12, 2008

Last updated

Jun 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dmyuncajallo@direct.westerndental.com

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.

• Village Dental Care

  • Dental Clinic/Center
  • Riverside, CA
  • NPI 1972922250
  Authorized official Same address or phone

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1558517342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10925 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053044",
            "telephone_number": "951-977-9991",
            "fax_number": "951-588-8552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10925 MAGNOLIA AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925053044",
            "telephone_number": "951-977-9991",
            "fax_number": "951-588-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "DAVID",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-12",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "57425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angelica Medina
• Bianca Medina
• Cristiaan Geronimo Medina, FNP-C
• Cynthia Medina
• David Medina Jr.
• Isela Medina, CHW
• Jenifer Medina
• Jessica Medina, BA, MS
• Marianella Medina
• Michelle R Medina, FNP-BC

• Dentist in Riverside, CA
• Providers in Riverside, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.