Individual provider Active NPI

Rodolfo C. Villasin, DMD, DDS

  • General Practice Dentistry
  • Daly City, CA
National Provider Identifier
1912967472
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D23704 Issued in CA
Practice address
341 Westlake Ctr
Suite 237
Daly City, CA 94015-1441
Phone
(650) 756-6211
Fax
(650) 756-3275
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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 D23704 CA Primary

Addresses

Primary practice location

341 Westlake Ctr
Suite 237
Daly City, CA 94015-1441

Mailing address

341 Westlake Center
237
Daly City, CA 94015-1355
Phone (650) 756-6211

Other identifiers 1

IdentifierTypeStateIssuer
142601OtherCAPMI DELTA CARE

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
D23704CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1912967472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 WESTLAKE CENTER",
            "address_2": "237",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151355",
            "telephone_number": "650-756-6211",
            "fax_number": "650-756-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 WESTLAKE CTR",
            "address_2": "SUITE 237",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940151441",
            "telephone_number": "650-756-6211",
            "fax_number": "650-756-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLASIN",
        "first_name": "RODOLFO",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "DMD, DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "D23704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PMI DELTA CARE",
            "identifier": "142601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.