Maria V Agustin, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49263 Issued in CA

Practice address

645 Sweetwawter Rd.
Spring Valley, CA 91977

Phone

(619) 464-0426

NPI assigned

Mar 21, 2008

Last updated

Jun 30, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1206057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1246320000000",
    "number": "1568633295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 SWEETWAWTER RD.",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "91977",
            "telephone_number": "619-464-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 SWEETWAWTER RD.",
            "city": "SPRING VALLEY",
            "state": "CA",
            "postal_code": "91977",
            "telephone_number": "619-464-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AGUSTIN",
        "first_name": "MARIA",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-21",
        "last_updated": "2009-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Spring Valley, CA
• Providers in Spring Valley, 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 Jun 30, 2009; 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.