Active NPI
Jesus Antonio Samaniego
- Dental Assistant
- Downey, CA
National Provider Identifier
1568609642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Assistant
- License
- 4490492
- Practice address
- 13235 Barlin Ave
Downey, CA 90242-5103 - Phone
- (562) 970-8612
- NPI assigned
- Jan 12, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | 4490492 | CA | Primary |
Addresses
Primary practice location
13235 Barlin Ave
Downey, CA 90242-5103
Mailing address
13235 Barlin Ave
Downey, CA 90242-5103
Phone (562) 970-8612
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4490492 | CA | MD | Dental Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1231718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1568609642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13235 BARLIN AVE",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902425103",
"telephone_number": "562-970-8612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13235 BARLIN AVE",
"city": "DOWNEY",
"state": "CA",
"postal_code": "902425103",
"telephone_number": "562-970-8612"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMANIEGO",
"first_name": "JESUS",
"middle_name": "ANTONIO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-01-12",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "126800000X",
"taxonomy_group": "",
"desc": "Dental Assistant",
"state": "CA",
"license": "4490492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Downey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.