Active NPI
Robert Wayne Aubuchon, DDS, MSD
- Pediatric Dentistry
- Oakland, CA
National Provider Identifier
1871667063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22128
- Practice address
- 3320 Webster Street
Oakland, CA 94609 - Phone
- (510) 452-4466
- Fax
- (510) 444-4272
- NPI assigned
- Nov 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 22128 | CA | Primary |
Addresses
Primary practice location
3320 Webster Street
Oakland, CA 94609
Mailing address
2801 Waterman Blvd.
Suite 190
Fairfield, CA 94534
Phone (707) 429-5450
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G93911 | Other | CA | DENTICAL |
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 |
|---|---|---|---|
| 22128 | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vincent Wong, DDS, a Professional Dental Corporation | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Oakland, CA
- NPI 1780135442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1378771200000",
"number": "1871667063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2801 WATERMAN BLVD.",
"address_2": "SUITE 190",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "94534",
"telephone_number": "707-429-5450",
"fax_number": "707-429-7109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 WEBSTER STREET",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94609",
"telephone_number": "510-452-4466",
"fax_number": "510-444-4272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUBUCHON",
"first_name": "ROBERT",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-20",
"last_updated": "2013-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "22128",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTICAL",
"identifier": "G93911",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.