NPIMap

Organization Active NPI

Daniel T. Estacio, DDS, Inc.

  • Preferred Provider Organization
  • Glendale, CA
National Provider Identifier
1649467291
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Preferred Provider OrganizationTaxonomy code 305R00000X
License
47886 Issued in CA
Legal business name
DANIEL T. ESTACIO, DDS, INC.
Practice address
1140 E Chevy Chase Dr
Glendale, CA 91205-2511
Phone
(818) 247-3387
Fax
(818) 247-2680
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Dr. Daniel Toribio Estacio, DDSNPI 1467571562
Title
Dentist/President
Phone
(818) 247-3387

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Preferred Provider Organization 305R00000X 47886 CA Primary

Addresses

Primary practice location

1140 E Chevy Chase Dr
Glendale, CA 91205-2511

Mailing address

1140 E Chevy Chase Dr
Glendale, CA 91205-2511
Phone (818) 247-3387

Other identifiers 1

IdentifierTypeStateIssuer
G-93853-01OtherCAMEDI-CAL PROVIDER NO

National Provider Directory

National Provider Directory

Locations

1140 E Chevy Chase Dr
Glendale, CA 91205
Phone (818) 247-3387

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1649467291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 E CHEVY CHASE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052511",
            "telephone_number": "818-247-3387",
            "fax_number": "818-247-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E CHEVY CHASE DR",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052511",
            "telephone_number": "818-247-3387",
            "fax_number": "818-247-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL T. ESTACIO, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "ESTACIO",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "TORIBIO",
        "authorized_official_title_or_position": "DENTIST/PRESIDENT",
        "authorized_official_telephone_number": "818-247-3387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "CA",
            "license": "47886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NO",
            "identifier": "G-93853-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.