Active NPI
Robert J Munoz, DDS
- Dentist
- Modesto, CA
National Provider Identifier
1891829206
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 20236
- Practice address
- 909 W Roseburg Ave
Suite a
Modesto, CA 95350-5028 - Phone
- (209) 526-3815
- Fax
- (209) 579-9521
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 20236 | CA | Primary |
Addresses
Primary practice location
909 W Roseburg Ave
Suite a
Modesto, CA 95350-5028
Mailing address
4325 Jacinthe CT
Modesto, CA 95356-9775
Phone (209) 543-6990
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20236 | Other | CA | DDS |
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 |
|---|---|---|---|
| 20236 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Munoz, Forbes, Souza, Lee, Kano & Conley a Dental Corp. | Dentist | 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.
-
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- Manteca, CA
- NPI 1558503060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1891829206",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4325 JACINTHE CT",
"city": "MODESTO",
"state": "CA",
"postal_code": "953569775",
"telephone_number": "209-543-6990",
"fax_number": "209-579-9521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "909 W ROSEBURG AVE",
"address_2": "SUITE A",
"city": "MODESTO",
"state": "CA",
"postal_code": "953505028",
"telephone_number": "209-526-3815",
"fax_number": "209-579-9521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-15",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "20236",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DDS",
"identifier": "20236",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.