Individual provider Active NPI

Abigail Theresa Masbrata, DDS

  • Dentist
  • Folsom, CA
National Provider Identifier
1922728195
Registry record updated Aug 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107830 Issued in CA
Practice address
2465 Iron Point Rd Ste 120
Folsom, CA 95630-8754
Phone
(916) 984-9600
NPI assigned
Aug 29, 2022
Last updated
Aug 29, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 107830 CA Primary

Addresses

Primary practice location

2465 Iron Point Rd Ste 120
Folsom, CA 95630-8754

Mailing address

5508 Butano Park Dr
Fremont, CA 94538-3200
Phone (510) 673-2012

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230119002041 CA Order and Referring Only - DentistPractitioner - Dentist 5193196665

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
O'Donnell Dental Corporation PastSince Sep 4, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661731200000",
    "number": "1922728195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5508 BUTANO PARK DR",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945383200",
            "telephone_number": "510-673-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 IRON POINT RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308754",
            "telephone_number": "916-984-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASBRATA",
        "first_name": "ABIGAIL",
        "middle_name": "THERESA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

Verify at the official NPI Registry.