Individual provider Active NPI

Dale Rubinchik, D.D.S., INC.

  • General Practice Dentistry
  • Redwood City, CA
National Provider Identifier
1912940685
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
31853 Issued in CA
Practice address
902 Woodside Rd
Redwood City, CA 94061-3611
Phone
(650) 365-8982
Fax
(650) 365-8928
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 31853 CA Primary

Addresses

Primary practice location

902 Woodside Rd
Redwood City, CA 94061-3611

Mailing address

902 Woodside Rd
Redwood City, CA 94061-3611
Phone (650) 365-8982

Other identifiers 1

IdentifierTypeStateIssuer
773380OtherCAUNITED CONCORDIA

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
31853CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912940685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 WOODSIDE RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940613611",
            "telephone_number": "650-365-8982",
            "fax_number": "650-365-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 WOODSIDE RD",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940613611",
            "telephone_number": "650-365-8982",
            "fax_number": "650-365-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBINCHIK",
        "first_name": "DALE",
        "credential": "D.D.S., INC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "31853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "773380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.