Individual provider Active NPI

Joel H Altshul

  • Endodontics
  • Vista, CA
National Provider Identifier
1639415540
Registry record updated Dec 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
31019 Issued in CA
Practice address
2023 W Vista Way Ste P
Vista, CA 92083-6030
Phone
(760) 630-4705
Fax
(760) 630-4609
NPI assigned
Dec 20, 2012
Last updated
Dec 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 31019 CA Primary

Addresses

Primary practice location

2023 W Vista Way Ste P
Vista, CA 92083-6030

Mailing address

2023 W Vista Way Ste P
Vista, CA 92083-6030
Phone (760) 630-4705

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
I20160422001302 CA Order and Referring Only - DentistPractitioner - Dentist 6305145574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Altshul Dental Corp Endodontics Past Accepting new patients
Wendy a Shumate MD Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1355961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355961600000",
    "number": "1639415540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 W VISTA WAY STE P",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836030",
            "telephone_number": "760-630-4705",
            "fax_number": "760-630-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 W VISTA WAY STE P",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920836030",
            "telephone_number": "760-630-4705",
            "fax_number": "760-630-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTSHUL",
        "first_name": "JOEL",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-20",
        "last_updated": "2012-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "31019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vista, CA

Sources for this page

Verify at the official NPI Registry.