Individual provider Active NPI

Mikan Sljivar, DDS

  • Dentist
  • Chula Vista, CA
National Provider Identifier
1801952080
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
39336 Issued in CA
Practice address
1040 Tierra del Rey
Suite 205
Chula Vista, CA 91910-7865
Phone
(619) 421-0500
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 39336 CA Primary

Addresses

Primary practice location

1040 Tierra del Rey
Suite 205
Chula Vista, CA 91910-7865

Mailing address

1040 Tierra del Rey
Suite 205
Chula Vista, CA 91910-7865

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

State licenses

LicenseStateTypeSpecialty
39336CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801952080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 TIERRA DEL REY",
            "address_2": "SUITE 205",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 TIERRA DEL REY",
            "address_2": "SUITE 205",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919107865",
            "telephone_number": "619-421-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLJIVAR",
        "first_name": "MIKAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "39336",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.