NPIMap

Organization Active NPI

John W. Bristow, D.D.S.

  • General Practice Dentistry
  • Vallejo, CA
National Provider Identifier
1558571802
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
27961 Issued in CA
Legal business name
JOHN W. BRISTOW, D.D.S.
Practice address
23 Rotary Way
Vallejo, CA 94591-8475
Phone
(707) 642-3319
Fax
(707) 642-7502
NPI assigned
May 23, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John W. Bristow, D.D.S.NPI 1174736581
Title
Owner
Phone
(707) 642-3319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 27961 CA Primary

Addresses

Primary practice location

23 Rotary Way
Vallejo, CA 94591-8475

Mailing address

23 Rotary Way
Vallejo, CA 94591-8475
Phone (707) 642-3319

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558571802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ROTARY WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918475",
            "telephone_number": "707-642-3319",
            "fax_number": "707-642-7502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 ROTARY WAY",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945918475",
            "telephone_number": "707-642-3319",
            "fax_number": "707-642-7502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN W. BRISTOW, D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRISTOW",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-642-3319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "27961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.