Individual provider Active NPI

Ferdinand De Ausen Pati, D.D.S.

  • Dentist
  • Glendale, CA
National Provider Identifier
1942422746
Registry record updated Sep 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
47304 Issued in CA
Practice address
918 E Colorado St
Glendale, CA 91205-1224
Phone
(818) 502-9925
Fax
(818) 502-1011
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 47304 CA Primary

Addresses

Primary practice location

918 E Colorado St
Glendale, CA 91205-1224

Mailing address

918 E Colorado St
Glendale, CA 91205-1224
Phone (818) 502-9925

Other identifiers 1

IdentifierTypeStateIssuer
B47304MedicaidCA

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
47304CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ferdinand D. Pati, D.D.S., Inc. Dentist Past 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": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1942422746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "918 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051224",
            "telephone_number": "818-502-9925",
            "fax_number": "818-502-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "918 E COLORADO ST",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912051224",
            "telephone_number": "818-502-9925",
            "fax_number": "818-502-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATI",
        "first_name": "FERDINAND",
        "middle_name": "DE AUSEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B47304",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.