Angelica Nieto, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

60200 Issued in CA

Practice address

78995 Highway 111 Ste 3
La Quinta, CA 92253-2397

Phone

(760) 771-8887

Fax

(760) 867-2603

NPI assigned

Mar 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Oral Surgery

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: anieto@direct.westerndental.com

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.

• Nieto Dental Corp

  • Oral and Maxillofacial Surgery Clinic/Center
  • La Quinta, CA
  • NPI 1265087985

  General Practice

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1891084836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "78995 HIGHWAY 111 STE 3",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "78995 HIGHWAY 111 STE 3",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922532397",
            "telephone_number": "760-771-8887",
            "fax_number": "760-867-2603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIETO",
        "first_name": "ANGELICA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Nguyen
• Ly Khanh Nguyen, PHARM.D.
• Thanh-VI Le Nguyen, O.D.
• Jodean Nicolette, M.D.
• Nieto Dental Corp
• Richard H Noble
• Lorenzo Nohra, RPH
• Saleem Noorali, LCSW
• Thomas Norum, M.D.
• Mary-Ellen O'Neill

• General Practice Dentistry in La Quinta, CA
• Providers in La Quinta, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.