Individual provider Active NPI

Efrain Jose Vargas, DDS

  • General Practice Dentistry
  • Saint Louis, MO
National Provider Identifier
1831674589
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2021042338 Issued in MO
Practice address
9601 Manchester Rd
Saint Louis, MO 63119-1333
Phone
(314) 274-6319
NPI assigned
Sep 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019031895 IL
General Practice Dentistry 1223G0001X DDS105941 CA
General Practice Dentistry 1223G0001X 2021042338 MO Primary

Addresses

Primary practice location

9601 Manchester Rd
Saint Louis, MO 63119-1333

Mailing address

9601 Manchester Rd
Saint Louis, MO 63119-1333
Phone (314) 274-6319

Other practice location 1

2995 Clairemont Dr Ste A
San Diego, CA 92117-6766
Phone (858) 200-0827

Other practice location 2

3737 Murphy Canyon Rd Ste C-2
San Diego, CA 92123-4454
Phone (858) 694-0790

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS105941CAMDGeneral Practice Dentistry
2021042338MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Heights Dentistry, PLLC Dentist PastSince Jan 1, 2021 Accepting new patients
Alex Sharifian DDS Rock Hill Dentistry PC Dentist PastSince Nov 16, 2021 Accepting new patients
Katayoun Afshar and Afshin Habashi Dental Corporation General Practice Past Accepting new patients
Huynh and Habashi Dental Corporation Dentist PastSince Feb 1, 2021 Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1831674589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191333",
            "telephone_number": "314-274-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 MANCHESTER RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191333",
            "telephone_number": "314-274-6319"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2995 Clairemont Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921176766",
            "country_code": "US",
            "telephone_number": "858-200-0827",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3737 Murphy Canyon Rd Ste C-2",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921234454",
            "country_code": "US",
            "telephone_number": "858-694-0790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VARGAS",
        "first_name": "EFRAIN",
        "middle_name": "JOSE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-28",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031895",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS105941",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2021042338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.