Individual provider Active NPI

Angelita U. Costales-Teotico, D.D.S.

  • General Practice Dentistry
  • Daly City, CA
National Provider Identifier
1710024922
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
41170 Issued in CA
Practice address
7311 Mission St
Suite K
Daly City, CA 94014-2657
Phone
(650) 757-9497
Fax
(650) 757-0103
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

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 41170 CA Primary

Addresses

Primary practice location

7311 Mission St
Suite K
Daly City, CA 94014-2657

Mailing address

7311 Mission St
Suite K
Daly City, CA 94014-2657
Phone (650) 757-9497

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
41170CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710024922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7311 MISSION ST",
            "address_2": "SUITE K",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142657",
            "telephone_number": "650-757-9497",
            "fax_number": "650-757-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7311 MISSION ST",
            "address_2": "SUITE K",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940142657",
            "telephone_number": "650-757-9497",
            "fax_number": "650-757-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTALES-TEOTICO",
        "first_name": "ANGELITA",
        "middle_name": "U.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "41170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, 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.