Individual provider Active NPI

Carl Joseph Fleischmann, DDS

  • General Practice Dentistry
  • Woodland, CA
National Provider Identifier
1578864401
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
59732 Issued in CA
Practice address
2041 Bronze Star Dr Ste 100
Woodland, CA 95776-5428
Phone
(530) 662-7592
Fax
(530) 668-6526
NPI assigned
Nov 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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 59732 CA Primary

Addresses

Primary practice location

2041 Bronze Star Dr Ste 100
Woodland, CA 95776-5428

Mailing address

2041 Bronze Star Dr Ste 100
Woodland, CA 95776-5428
Phone (530) 662-7592

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
I20150915002619 CA Order and Referring Only - DentistPractitioner - Dentist 6608183256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59732CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gill and Ghazal Dental Corporation General Practice 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1578864401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 BRONZE STAR DR STE 100",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765428",
            "telephone_number": "530-662-7592",
            "fax_number": "530-668-6526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 BRONZE STAR DR STE 100",
            "city": "WOODLAND",
            "state": "CA",
            "postal_code": "957765428",
            "telephone_number": "530-662-7592",
            "fax_number": "530-668-6526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEISCHMANN",
        "first_name": "CARL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland, CA

Sources for this page

Verify at the official NPI Registry.