Individual provider Active NPI

Emmanuel Dimitri Delagrammaticas, DDS

  • General Practice Dentistry
  • San Marcos, CA
National Provider Identifier
1578660452
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31598 Issued in CA
Practice address
1145 San Marino Dr
Suite 303
San Marcos, CA 92078-4634
Phone
(760) 471-0475
Fax
(760) 471-6270
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

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 31598 CA Primary

Addresses

Primary practice location

1145 San Marino Dr
Suite 303
San Marcos, CA 92078-4634

Mailing address

1145 San Marino Dr
Suite 303
San Marcos, CA 92078-4634
Phone (760) 471-0475

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20151204002469 CA Practitioner - Oral Surgery 9739489295 Practice locations: San Marcos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578660452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 SAN MARINO DR",
            "address_2": "SUITE 303",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784634",
            "telephone_number": "760-471-0475",
            "fax_number": "760-471-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 SAN MARINO DR",
            "address_2": "SUITE 303",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920784634",
            "telephone_number": "760-471-0475",
            "fax_number": "760-471-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAGRAMMATICAS",
        "first_name": "EMMANUEL",
        "middle_name": "DIMITRI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.