Individual provider Active NPI

Amanda Delgado, DDS

  • Dentist
  • Newhall, CA
National Provider Identifier
1770316952
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
110536 Issued in CA
Practice address
23920 Fambrough St
Newhall, CA 91321-3440
Phone
(661) 670-3743
NPI assigned
Aug 22, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 110536 CA Primary

Addresses

Primary practice location

23920 Fambrough St
Newhall, CA 91321-3440

Mailing address

23920 Fambrough St
Newhall, CA 91321-3440
Phone (661) 670-3743

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
I20250813001674 CA Order and Referring Only - DentistPractitioner - Dentist 6002314564

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110536CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1724284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1770316952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23920 FAMBROUGH ST",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213440",
            "telephone_number": "661-670-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23920 FAMBROUGH ST",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913213440",
            "telephone_number": "661-670-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADO",
        "first_name": "AMANDA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "110536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.