Active NPI
Antonio Vera, DDS
- Endodontics
- Fremont, CA
National Provider Identifier
1811053960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 52953
- Practice address
- 1895 Mowry Ave
Suite 110
Fremont, CA 94538-1737 - Phone
- (510) 796-3782
- Fax
- (510) 796-5139
- NPI assigned
- Dec 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 52953 | CA | Primary |
| Endodontics | 1223E0200X | 21427 | MA |
Addresses
Primary practice location
1895 Mowry Ave
Suite 110
Fremont, CA 94538-1737
Mailing address
1895 Mowry Ave
Suite 110
Fremont, CA 94538-1737
Phone (510) 895-1470
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
| License | State | Type | Specialty |
|---|---|---|---|
| 21427 | MA | MD | Endodontist |
| 52953 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263859200000",
"number": "1811053960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1895 MOWRY AVE",
"address_2": "SUITE 110",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381737",
"telephone_number": "510-895-1470",
"fax_number": "510-796-5139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1895 MOWRY AVE",
"address_2": "SUITE 110",
"city": "FREMONT",
"state": "CA",
"postal_code": "945381737",
"telephone_number": "510-796-3782",
"fax_number": "510-796-5139"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERA",
"first_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-30",
"last_updated": "2010-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "52953",
"primary": true
},
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MA",
"license": "21427",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.