Individual provider Active NPI

Kristian Eli Cabugao, DDS

  • General Practice Dentistry
  • San Diego, CA
National Provider Identifier
1932200342
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53973 Issued in CA
Practice address
10645 Tierrasanta Blvd
Suite B
San Diego, CA 92124-2614
Phone
(858) 277-6080
Fax
(858) 277-4773
NPI assigned
Sep 26, 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 53973 CA Primary

Addresses

Primary practice location

10645 Tierrasanta Blvd
Suite B
San Diego, CA 92124-2614

Mailing address

10645 Tierrasanta Blvd
Suite B
San Diego, CA 92124-2614
Phone (858) 277-6080

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

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932200342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10645 TIERRASANTA BLVD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242614",
            "telephone_number": "858-277-6080",
            "fax_number": "858-277-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10645 TIERRASANTA BLVD",
            "address_2": "SUITE B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921242614",
            "telephone_number": "858-277-6080",
            "fax_number": "858-277-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABUGAO",
        "first_name": "KRISTIAN",
        "middle_name": "ELI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, 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.