Active NPI
Donald Andson Dillworth, DDS
- Dentist
- Bakersfield, CA
National Provider Identifier
1649495383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 44307
- Practice address
- 4022 Niles St
Bakersfield, CA 93306-4630 - Phone
- (661) 871-3736
- Fax
- (661) 871-7417
- NPI assigned
- Apr 16, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 44307 | CA | Primary |
Addresses
Primary practice location
4022 Niles St
Bakersfield, CA 93306-4630
Mailing address
4022 Niles St
Bakersfield, CA 93306-4630
Phone (661) 871-3736
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D44307 | Other | CA | DENTI-CAL RENDERING |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 44307 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Depot | Past | Accepting new patients | |
| Hacienda Dental | 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.
-
- Dental Clinic/Center
- Bakersfield, CA
- NPI 1205169729
-
- Dental Clinic/Center
- Bakersfield, CA
- NPI 1275772634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649495383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4022 NILES ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933064630",
"telephone_number": "661-871-3736",
"fax_number": "661-871-7417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4022 NILES ST",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933064630",
"telephone_number": "661-871-3736",
"fax_number": "661-871-7417"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLWORTH",
"first_name": "DONALD",
"middle_name": "ANDSON",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "44307",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTI-CAL RENDERING",
"identifier": "D44307",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, 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.