Individual provider Active NPI

David R Podsadecki, DDS

  • Dentist
  • Newhall, CA
National Provider Identifier
1619062288
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
26696 Issued in CA
Practice address
26316 Friendly Valley Parkway
Newhall, CA 91321
Phone
(661) 251-2300
Fax
(661) 251-2343
NPI assigned
Oct 3, 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
Dentist 122300000X 26696 CA Primary

Addresses

Primary practice location

26316 Friendly Valley Parkway
Newhall, CA 91321

Mailing address

26316 Friendly Valley Parkway
Newhall, CA 91321
Phone (661) 251-2300

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
I20150803000628 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1658685797

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619062288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26316 FRIENDLY VALLEY PARKWAY",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "91321",
            "telephone_number": "661-251-2300",
            "fax_number": "661-251-2343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26316 FRIENDLY VALLEY PARKWAY",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "91321",
            "telephone_number": "661-251-2300",
            "fax_number": "661-251-2343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PODSADECKI",
        "first_name": "DAVID",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "26696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.