Individual provider Active NPI

John Sepe, D.D.S.

  • General Practice Dentistry
  • Poway, CA
National Provider Identifier
1750505194
Registry record updated Oct 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
35025 Issued in CA
Practice address
15835 Pomerado Rd Ste 203
Poway, CA 92064-2042
Phone
(858) 485-8012
Fax
(858) 485-5615
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2012

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 35025 CA Primary

Addresses

Primary practice location

15835 Pomerado Rd Ste 203
Poway, CA 92064-2042

Mailing address

12775 Gate Dr
Poway, CA 92064-5870
Phone (858) 705-0406

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": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349395200000",
    "number": "1750505194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12775 GATE DR",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645870",
            "telephone_number": "858-705-0406",
            "fax_number": "858-513-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15835 POMERADO RD STE 203",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642042",
            "telephone_number": "858-485-8012",
            "fax_number": "858-485-5615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPE",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2012-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "35025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.