Active NPI
Dunya Antwan, DDS
- Dentist
- Vista, CA
National Provider Identifier
1659580710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 55683
- Practice address
- 520 W Vista Way
Vista, CA 92083-5704 - Phone
- (760) 941-1906
- Fax
- (760) 941-1906
- NPI assigned
- May 22, 2007
- Sex
- Female
- 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 | 55683 | CA | Primary |
Addresses
Primary practice location
520 W Vista Way
Vista, CA 92083-5704
Mailing address
520 W. Vista Way
Vista, CA 92083
Phone (760) 941-1906
Other practice location 1
10450 Friars Rd
suite g
San Diego, CA 92120-2311
Phone (619) 640-5100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D55683 | Medicaid | CA |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730010672 | CA | Order and Referring Only - Dentist | 5496069841 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55683 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dunya G Antwan DDS Inc, | Dentist | Past | Accepting new patients |
| Dunya Antwan DDS Inc. | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Vista, CA
- NPI 1407364102
-
- Dentist
- San Diego, CA
- NPI 1538405014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1659580710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 W. VISTA WAY",
"city": "VISTA",
"state": "CA",
"postal_code": "92083",
"telephone_number": "760-941-1906",
"fax_number": "760-941-1907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 W VISTA WAY",
"city": "VISTA",
"state": "CA",
"postal_code": "920835704",
"telephone_number": "760-941-1906",
"fax_number": "760-941-1906"
}
],
"practiceLocations": [
{
"address_1": "10450 Friars Rd",
"address_2": "suite g",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921202311",
"country_code": "US",
"telephone_number": "619-640-5100",
"fax_number": "619-640-5101",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ANTWAN",
"first_name": "DUNYA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "55683",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D55683",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.