Individual provider Active NPI

Myra A. Alcala, DMD

  • Dentist
  • Chula Vista, CA
National Provider Identifier
1750583407
Registry record updated May 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54119 Issued in CA
Practice address
1456 Melrose Ave
Chula Vista, CA 91911-5569
Phone
(619) 409-1490
Fax
(619) 409-7160
NPI assigned
Jun 4, 2007
Last updated
May 6, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54119 CA Primary

Addresses

Primary practice location

1456 Melrose Ave
Chula Vista, CA 91911-5569

Mailing address

1456 Melrose Ave
Chula Vista, CA 91911-5569
Phone (619) 409-1490

Other identifiers 1

IdentifierTypeStateIssuer
D54119MedicaidCA

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367798400000",
    "number": "1750583407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1456 MELROSE AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919115569",
            "telephone_number": "619-409-1490",
            "fax_number": "619-409-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1456 MELROSE AVE",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919115569",
            "telephone_number": "619-409-1490",
            "fax_number": "619-409-7160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALCALA",
        "first_name": "MYRA",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D54119",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2013; 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.