Ivana Racic, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

104932 Issued in CA

Practice address

230 W G St Ste H
San Diego, CA 92101-6026

Phone

(843) 489-6692

NPI assigned

Jun 16, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Racic Dental Corporation

  • Dental Clinic/Center
  • San Diego, CA
  • NPI 1285209148
  NPD Authorized official

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

{
    "created_epoch": "1592265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622332800000",
    "number": "1558987487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W G ST STE H",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016026",
            "telephone_number": "843-489-6692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W G ST STE H",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921016026",
            "telephone_number": "843-489-6692"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11835 Carmel Mountain Rd Ste 1306",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921284609",
            "country_code": "US",
            "telephone_number": "858-295-0186",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Main St Ste C130",
            "address_purpose": "LOCATION",
            "city": "Vista",
            "state": "CA",
            "postal_code": "920835858",
            "country_code": "US",
            "telephone_number": "760-790-4267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RACIC",
        "first_name": "IVANA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-16",
        "last_updated": "2021-05-30",
        "certification_date": "2021-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ivanaracic@hotmail.com",
            "affiliation": "N",
            "address_1": "35 Main St Ste C130",
            "city": "Vista",
            "state": "CA",
            "country_code": "US",
            "postal_code": "920835858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachelle T. Flores DMD, Inc
• Liman Rachels, L.AC
• Clifford Rachlin
• Elijah Rachlin
• Racic Dental Corporation
• Tashina Racine, RN
• Ryan David Racino, PHARM.D., AAHIVP
• Catalina Racu
• Gabrielle Raczek
• Amir H Rad, M.D

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.