Active NPI
Carlos Enrique Sibaja, DDS
- Dentist
- Vista, CA
National Provider Identifier
1891069522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61133
- Practice address
- 895 E Vista Way # C
Vista, CA 92084-5237 - Phone
- (760) 201-3414
- NPI assigned
- Feb 27, 2012
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 61133 | CA | Primary |
Addresses
Primary practice location
895 E Vista Way # C
Vista, CA 92084-5237
Mailing address
895 E Vista Way # C
Vista, CA 92084-5237
Phone (760) 201-3414
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 |
|---|---|---|---|
| 61133 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1891069522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 E VISTA WAY # C",
"city": "VISTA",
"state": "CA",
"postal_code": "920845237",
"telephone_number": "760-201-3414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 E VISTA WAY # C",
"city": "VISTA",
"state": "CA",
"postal_code": "920845237",
"telephone_number": "760-201-3414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIBAJA",
"first_name": "CARLOS",
"middle_name": "ENRIQUE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-27",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61133",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.