Individual provider Active NPI

Stephen Jay Riggio, DDS

  • Public Health Dentistry
  • Jackson, CA
National Provider Identifier
1740284793
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
28798 Issued in CA
Practice address
15515 Daltons Dr
Jackson, CA 95642-9344
Phone
(209) 223-8460
Fax
(209) 223-8464
NPI assigned
Jun 8, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
Public Health Dentistry 1223D0001X 28798 CA Primary

Addresses

Primary practice location

15515 Daltons Dr
Jackson, CA 95642-9344

Mailing address

PO Box 2080
Tuolumne, CA 95379-2080
Phone (209) 928-4277

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

NPI Registry JSON

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740284793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "TUOLUMNE",
            "state": "CA",
            "postal_code": "953792080",
            "telephone_number": "209-928-4277",
            "fax_number": "209-928-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15515 DALTONS DR",
            "city": "JACKSON",
            "state": "CA",
            "postal_code": "956429344",
            "telephone_number": "209-223-8460",
            "fax_number": "209-223-8464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIGGIO",
        "first_name": "STEPHEN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "28798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, 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.