Individual provider Active NPI

Violet Feldman, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1790855583
Registry record updated Jan 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50566 Issued in CA
Practice address
4511 Campobello St
San Diego, CA 92130-2715
Phone
(858) 231-4889
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2017

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 50566 CA Primary

Addresses

Primary practice location

4511 Campobello St
San Diego, CA 92130-2715

Mailing address

3400 Del Lago Blvd
Ste C
Escondido, CA 92029-7427
Phone (760) 746-8777

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
I20170118002062 CA Order and Referring Only - DentistPractitioner - Dentist 2769764208

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50566CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483488000000",
    "number": "1790855583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DEL LAGO BLVD",
            "address_2": "STE C",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920297427",
            "telephone_number": "760-746-8777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 CAMPOBELLO ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302715",
            "telephone_number": "858-231-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELDMAN",
        "first_name": "VIOLET",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2017-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.