Individual provider Active NPI

Adrian Teodor Clinciu, D.D.S.

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1902063985
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
54653 Issued in CA
Practice address
825 E Bidwell St Ste 400
Folsom, CA 95630-3349
Phone
(916) 984-4591
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 54653 CA Primary

Addresses

Primary practice location

825 E Bidwell St Ste 400
Folsom, CA 95630-3349

Mailing address

7801 Lazy Trail CT
Orangevale, CA 95662-2123
Phone (916) 662-6295

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

LicenseStateTypeSpecialty
54653CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211155200000",
    "number": "1902063985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 LAZY TRAIL CT",
            "city": "ORANGEVALE",
            "state": "CA",
            "postal_code": "956622123",
            "telephone_number": "916-662-6295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E BIDWELL ST STE 400",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303349",
            "telephone_number": "916-984-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINCIU",
        "first_name": "ADRIAN",
        "middle_name": "TEODOR",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.