Individual provider Active NPI

Agnes T Stockell, DMD

  • Dentist
  • San Diego, CA
National Provider Identifier
1851810188
Registry record updated Jun 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108649 Issued in CA
Practice address
5060 Logan Ave
San Diego, CA 92113-3014
Phone
(949) 413-4090
NPI assigned
Sep 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS041481 PA
Dentist 122300000X 108649 CA Primary

Addresses

Primary practice location

5060 Logan Ave
San Diego, CA 92113-3014

Mailing address

5060 Logan Ave
San Diego, CA 92113-3014
Phone (949) 413-4090

Other practice location 1

315 McHugh Blvd
Camp Lejeune, NC 28547-2511
Phone (910) 451-2208 ext. 203

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
I20231024004204 CA Order and Referring Only - DentistPractitioner - Dentist 6406202621

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108649CAMDMental Health Counselor
DS041481PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Mariechris Ancheta Sapinoso DDS PC CurrentSince Jun 8, 2025 Accepting new patients

Locations

5060 Logan Ave
San Diego, CA 92113
Phone (619) 262-0706

Organizations & group practices 1

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749168000000",
    "number": "1851810188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921133014",
            "telephone_number": "949-413-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 LOGAN AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921133014",
            "telephone_number": "949-413-4090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 McHugh Blvd",
            "address_purpose": "LOCATION",
            "city": "Camp Lejeune",
            "state": "NC",
            "postal_code": "285472511",
            "country_code": "US",
            "telephone_number": "910-451-2208 x203",
            "fax_number": "910-451-8036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STOCKELL",
        "first_name": "AGNES",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2025-06-06",
        "certification_date": "2025-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041481",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.