Individual provider Active NPI

Dan Benjamin Sizemore, DDS

  • General Practice Dentistry
  • San Dimas, CA
National Provider Identifier
1578579900
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28239 Issued in CA
Practice address
213 N San Dimas Ave
San Dimas, CA 91773-2649
Phone
(909) 599-3398
Fax
(909) 599-1398
NPI assigned
Jul 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28239 CA Primary

Addresses

Primary practice location

213 N San Dimas Ave
San Dimas, CA 91773-2649

Mailing address

213 N San Dimas Ave
San Dimas, CA 91773-2649
Phone (909) 599-3398

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

LicenseStateTypeSpecialty
28239CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Toan D Nguyen DDS Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578579900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N SAN DIMAS AVE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732649",
            "telephone_number": "909-599-3398",
            "fax_number": "909-599-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N SAN DIMAS AVE",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "917732649",
            "telephone_number": "909-599-3398",
            "fax_number": "909-599-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIZEMORE",
        "first_name": "DAN",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Dimas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.