Individual provider Active NPI

Guobin He, D.D.S.

  • Dentist
  • Poway, CA
National Provider Identifier
1750797288
Registry record updated Jun 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63576 Issued in CA
Practice address
15525 Pomerado Rd Ste C9
Poway, CA 92064-2426
Phone
(858) 275-6507
Fax
(858) 275-6508
NPI assigned
Jul 3, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63576 CA Primary

Addresses

Primary practice location

15525 Pomerado Rd Ste C9
Poway, CA 92064-2426

Mailing address

15525 Pomerado Rd Ste C9
Poway, CA 92064-2426
Phone (858) 275-6507

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160512000843 CA Order and Referring Only - DentistPractitioner - Dentist 9335438415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Guobin He DDS Vista Inc Current Accepting new patients
Guobin He DDS Vista Inc Current Accepting new patients
Guobin He DDS Inc CurrentSince Jun 22, 2021 Accepting new patients

Locations

15525 Pomerado Rd
Ste C9
Poway, CA 92064
Phone (858) 275-6507

13422 Pomerado Rd
Ste 202
Poway, CA 92064
Phone (858) 679-0142

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623801600000",
    "number": "1750797288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE C9",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642426",
            "telephone_number": "858-275-6507",
            "fax_number": "858-275-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15525 POMERADO RD STE C9",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642426",
            "telephone_number": "858-275-6507",
            "fax_number": "858-275-6508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HE",
        "first_name": "GUOBIN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-03",
        "last_updated": "2021-06-16",
        "certification_date": "2021-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poway, CA

Sources for this page

Verify at the official NPI Registry.