Individual provider Active NPI

Stephanie D Moniz, DDS

  • Pediatric Dentistry
  • San Francisco, CA
National Provider Identifier
1619265410
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
60051 Issued in CA
Practice address
2155 Webster St
San Francisco, CA 94115-2333
Phone
(415) 929-6400
NPI assigned
Jul 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 60051 CA Primary

Addresses

Primary practice location

2155 Webster St
San Francisco, CA 94115-2333

Mailing address

2155 Webster St
San Francisco, CA 94115-2333
Phone (415) 929-6400

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
I20151020000293 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 3375852023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60051CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1619265410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 WEBSTER ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152333",
            "telephone_number": "415-929-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 WEBSTER ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941152333",
            "telephone_number": "415-929-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONIZ",
        "first_name": "STEPHANIE",
        "middle_name": "D",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "60051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.