Individual provider Active NPI

Ana Vargas Godoy, D.D.S.

  • Dentist
  • Fontana, CA
National Provider Identifier
1831403468
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
59589 Issued in CA
Practice address
14755 Foothill Blvd
Fontana, CA 92335-8025
Phone
(909) 349-1360
NPI assigned
Aug 6, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 59589 CA
Dentist 122300000X 59589 CA Primary

Addresses

Primary practice location

14755 Foothill Blvd
Fontana, CA 92335-8025

Mailing address

939 W Cumberland St
Upland, CA 91786-2729
Phone (408) 509-5966

Other names 1

  • Dr. Ana Vargas Former name

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
59589CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1831403468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "939 W CUMBERLAND ST",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917862729",
            "telephone_number": "408-509-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14755 FOOTHILL BLVD",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923358025",
            "telephone_number": "909-349-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GODOY",
        "first_name": "ANA",
        "middle_name": "VARGAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-06",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "59589",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "59589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANA",
            "last_name": "VARGAS",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; 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.