Active NPI
Michael Narodovich, DMD
- Dentist
- Citrus Heights, CA
National Provider Identifier
1891958518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57101
- Practice address
- 6994 Sunrise BL
Citrus Heights, CA 95610-1243 - Phone
- (267) 978-6077
- NPI assigned
- Jul 2, 2008
- Last updated
- Jul 2, 2008
- 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 | 57101 | CA | Primary |
Addresses
Primary practice location
6994 Sunrise BL
Citrus Heights, CA 95610-1243
Mailing address
400 Connor Cir
Sacramento, CA 95835-1243
Phone (267) 978-6077
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161208001950 | CA | Order and Referring Only - Dentist | 6103106190 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57101 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1891958518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 CONNOR CIR",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958351243",
"telephone_number": "267-978-6077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6994 SUNRISE BL",
"city": "CITRUS HEIGHTS",
"state": "CA",
"postal_code": "956101243",
"telephone_number": "267-978-6077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NARODOVICH",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-02",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Citrus Heights, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.