NPIMap

Organization Active NPI

Eugene V Espiritu, DMD Professional Dental Corporation

  • Dentist
  • San Bruno, CA
National Provider Identifier
1699045989
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
33758 Issued in CA
Legal business name
EUGENE V ESPIRITU, DMD PROFESSIONAL DENTAL CORPORATION
Practice address
1230 El Camino Real Ste K
San Bruno, CA 94066-1300
Phone
(650) 875-6808
Fax
(650) 875-3755
NPI assigned
Jan 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Authorized official

Name
Eugene Velarde Espiritu, DMDNPI 1083600159
Title
Owner
Phone
(650) 875-6808

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
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 33758 CA Primary

Addresses

Primary practice location

1230 El Camino Real Ste K
San Bruno, CA 94066-1300

Mailing address

1230 El Camino Real Ste K
San Bruno, CA 94066-1300
Phone (650) 875-6808

Other identifiers 3

IdentifierTypeStateIssuer
B33758-01OtherCADELTA STATE GOVT PROGRAM
775195OtherCAUNITED CONCORDIA
143260OtherCAUNITED HEALTHCARE

National Provider Directory

National Provider Directory

Locations

1230 El Camino Real
Ste K
San Bruno, CA 94066
Phone (650) 875-6808

Practitioners & affiliated clinicians

Practitioners 2

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": "1325635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325635200000",
    "number": "1699045989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 EL CAMINO REAL STE K",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661300",
            "telephone_number": "650-875-6808",
            "fax_number": "650-875-3755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 EL CAMINO REAL STE K",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940661300",
            "telephone_number": "650-875-6808",
            "fax_number": "650-875-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUGENE V ESPIRITU, DMD PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A",
        "authorized_official_last_name": "ESPIRITU",
        "authorized_official_first_name": "EUGENE",
        "authorized_official_middle_name": "VELARDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-875-6808",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "33758",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA STATE GOVT PROGRAM",
            "identifier": "B33758-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "775195",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "143260",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bruno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; 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.