Active NPI
Ekta Jaiswal
- Dentist
- Chula Vista, CA
National Provider Identifier
1598942500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56722
- Practice address
- 1101 Broadway
Chula Vista, CA 91911-2706 - Phone
- (714) 480-3000
- NPI assigned
- Jan 22, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 56722 | CA | Primary |
Addresses
Primary practice location
1101 Broadway
Chula Vista, CA 91911-2706
Mailing address
11850 Cypress Canyon Rd
Unit 2
San Diego, CA 92131-5715
Phone (619) 251-4234
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150824000533 | CA | Order and Referring Only - Dentist | 3072828839 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, 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.
-
- General Practice Dentistry
- Chula Vista, CA
- NPI 1982768487
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200960000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1598942500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11850 CYPRESS CANYON RD",
"address_2": "UNIT 2",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921315715",
"telephone_number": "619-251-4234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 BROADWAY",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "919112706",
"telephone_number": "714-480-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAISWAL",
"first_name": "EKTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-22",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.