Individual provider Active NPI

Philip John Abeldt, D.D.S.

  • General Practice Dentistry
  • Lodi, CA
National Provider Identifier
1770568636
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30939 Issued in CA
Practice address
316 S Crescent Ave
Lodi, CA 95240-3904
Phone
(209) 369-3617
Fax
(209) 369-0498
NPI assigned
Dec 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 30939 CA Primary

Addresses

Primary practice location

316 S Crescent Ave
Lodi, CA 95240-3904

Mailing address

316 S Crescent Ave
Lodi, CA 95240-3904
Phone (209) 369-3617

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770568636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S CRESCENT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403904",
            "telephone_number": "209-369-3617",
            "fax_number": "209-369-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 S CRESCENT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952403904",
            "telephone_number": "209-369-3617",
            "fax_number": "209-369-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABELDT",
        "first_name": "PHILIP",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.