Individual provider Active NPI

Andrew Salvador Subido, DDS

  • Dental Anesthesiology
  • Larkspur, CA
National Provider Identifier
1912155276
Registry record updated Jul 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental AnesthesiologyTaxonomy code 1223D0004X
License
1955 Issued in CA
Practice address
428 Magnolia Ave
Larkspur, CA 94939-2035
Phone
(415) 924-7900
Fax
(415) 924-7901
NPI assigned
Aug 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Anesthesiology 1223D0004X 1955 CA Primary
General Practice Dentistry 1223G0001X 57468 CA

Addresses

Primary practice location

428 Magnolia Ave
Larkspur, CA 94939-2035

Mailing address

428 Magnolia Ave
Larkspur, CA 94939-2035
Phone (415) 924-7900

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170131001385 CA Order and Referring Only - Other (Non-Physician) 3678855418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57468CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hyatt Subido Dental Group, Inc, a Professional Corporation General Practice PastSince Nov 24, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1912155276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949392035",
            "telephone_number": "415-924-7900",
            "fax_number": "415-924-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 MAGNOLIA AVE",
            "city": "LARKSPUR",
            "state": "CA",
            "postal_code": "949392035",
            "telephone_number": "415-924-7900",
            "fax_number": "415-924-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUBIDO",
        "first_name": "ANDREW",
        "middle_name": "SALVADOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-28",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CA",
            "license": "1955",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57468",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Larkspur, CA

Sources for this page

Verify at the official NPI Registry.