Russel R Jacinto, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

37841 Issued in CA

Practice address

144 N Glendale Ave
#100
Glendale, CA 91206-4903

Phone

(818) 240-6705

Fax

(818) 240-3758

NPI assigned

Jan 5, 2007

Last updated

Jun 18, 2015By the provider in NPPES

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

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

Practice roles

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.

• Russel R Jacinto DMD Inc

  • General Practice Dentistry
  • Glendale, CA
  • NPI 1881060838
  NPD (past) Authorized official

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434585600000",
    "number": "1578610903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 N GLENDALE AVE",
            "address_2": "#100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064903",
            "telephone_number": "818-240-6705",
            "fax_number": "818-240-3758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "144 N GLENDALE AVE",
            "address_2": "#100",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064903",
            "telephone_number": "818-240-6705",
            "fax_number": "818-240-3758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACINTO",
        "first_name": "RUSSEL",
        "middle_name": "R",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2015-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "37841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• J.Ting Medical Corporation
• Emily Jabourian
• Jack Bayramyan D.D.S., Inc. (Kids & Family Dental Place)
• Shirley Jackson-Poordawood
• Dakhari Jackson
• Jacob E Tauber MD a Professional
• Jacob E. Tauber, MD, a Professional Corporation

• Dentist in Glendale, CA
• Providers in Glendale, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2015; 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.