NPIMap

Organization Active NPI

Colin S. Ilas D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1629616479
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COLIN S. ILAS D.D.S.
Practice address
1206 N Capitol Ave Ste 101
San Jose, CA 95132-2572
Phone
(408) 928-1450
Fax
(408) 928-1454
NPI assigned
Dec 11, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Authorized official

Name
Linnette Felipe Mangoba
Title
Office Manager
Phone
(408) 928-1450

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1206 N Capitol Ave Ste 101
San Jose, CA 95132-2572

Mailing address

1206 N Capitol Ave Ste 101
San Jose, CA 95132-2572
Phone (408) 928-1450

Other practice location 1

2030 Diamond Blvd Ste 25
Concord, CA 94520-5753
Phone (925) 687-8000

National Provider Directory

National Provider Directory
Tax ID family
Colin S Ilas DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1206 N Capitol Ave
Ste 101
San Jose, CA 95132
Phone (408) 928-1450

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576022400000",
    "number": "1629616479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 N CAPITOL AVE STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322572",
            "telephone_number": "408-928-1450",
            "fax_number": "408-928-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 N CAPITOL AVE STE 101",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951322572",
            "telephone_number": "408-928-1450",
            "fax_number": "408-928-1454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Diamond Blvd Ste 25",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945205753",
            "country_code": "US",
            "telephone_number": "925-687-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COLIN S. ILAS D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A",
        "authorized_official_last_name": "MANGOBA",
        "authorized_official_first_name": "LINNETTE",
        "authorized_official_middle_name": "FELIPE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "408-928-1450"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.