Individual provider Active NPI

Paul Delgadillo, DDS

  • General Practice Dentistry
  • Alameda, CA
National Provider Identifier
1649295197
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14920 Issued in TX
Practice address
Uscg Island Dental Clinic
Alameda, CA 94501
Phone
(510) 437-3615
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 14920 TX Primary

Addresses

Primary practice location

Uscg Island Dental Clinic
Alameda, CA 94501

Mailing address

1301 Clay St Ste 170N
Mlcpac(Kom)
Oakland, CA 94612-5216
Phone (510) 637-1229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14920TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649295197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 CLAY ST STE 170N",
            "address_2": "MLCPAC(KOM)",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946125216",
            "telephone_number": "510-637-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USCG ISLAND DENTAL CLINIC",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "94501",
            "telephone_number": "510-437-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADILLO",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "14920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.