NPIMap

Organization Active NPI

Fillmore Dental Spa

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1881884930
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43656 Issued in CA
Legal business name
FILLMORE DENTAL SPA
Practice address
3220 Fillmore St
San Francisco, CA 94123-3403
Phone
(415) 614-9850
Fax
(415) 614-9881
NPI assigned
Jul 25, 2007
Last updated
Jul 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Cecila Santos-Berkowitz, D.M.D.
Title
Owner
Phone
(415) 614-9850

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 43656 CA Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 43590 CA

Addresses

Primary practice location

3220 Fillmore St
San Francisco, CA 94123-3403

Mailing address

3220 Fillmore St
San Francisco, CA 94123-3403
Phone (415) 614-9850

Other identifiers 2

IdentifierTypeStateIssuer
53490OtherCAPERIODONTIST
43656OtherCAGENERAL DENTIST

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1881884930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941233403",
            "telephone_number": "415-614-9850",
            "fax_number": "415-614-9881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 FILLMORE ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941233403",
            "telephone_number": "415-614-9850",
            "fax_number": "415-614-9881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FILLMORE DENTAL SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "SANTOS-BERKOWITZ",
        "authorized_official_first_name": "CECILA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-614-9850",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43656",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "43590",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERIODONTIST",
            "identifier": "53490",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GENERAL DENTIST",
            "identifier": "43656",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.