Active NPI
Rachelle Joy De Eyoy Magtanong-Madrid, DDS
- General Practice Dentistry
- San Francisco, CA
National Provider Identifier
1891083242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 60528
- Practice address
- 2055 Sacramento St Apt 605
San Francisco, CA 94109-3321 - Phone
- (858) 829-4176
- NPI assigned
- Jul 19, 2011
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 60528 | CA | Primary |
Addresses
Primary practice location
2055 Sacramento St Apt 605
San Francisco, CA 94109-3321
Mailing address
2055 Sacramento St Apt 605
San Francisco, CA 94109-3321
Phone (858) 829-4176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jan 21, 2016 through Jan 21, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60528 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1891083242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 SACRAMENTO ST APT 605",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941093321",
"telephone_number": "858-829-4176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2055 SACRAMENTO ST APT 605",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941093321",
"telephone_number": "858-829-4176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAGTANONG-MADRID",
"first_name": "RACHELLE JOY",
"middle_name": "DE EYOY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "60528",
"primary": true
}
],
"identifiers": [],
"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 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.