Individual provider Active NPI

Emilio Muro, D.D.S.

  • General Practice Dentistry
  • Palm Desert, CA
National Provider Identifier
1952594103
Registry record updated Apr 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
56232 Issued in CA
Practice address
72855 Fred Waring Dr Ste C17
Suite C17
Palm Desert, CA 92260-9372
Phone
(760) 561-5459
Fax
(760) 670-3292
NPI assigned
Aug 21, 2007
Last updated
Apr 8, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2016

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 56232 CA Primary

Addresses

Primary practice location

72855 Fred Waring Dr Ste C17
Suite C17
Palm Desert, CA 92260-9372

Mailing address

72855 Fred Waring Dr
Suite C17
Palm Desert, CA 92260-9368
Phone (760) 561-5459

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
I20160602002557 CA Order and Referring Only - DentistPractitioner - Dentist 1153611132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56232CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Muro Dental Corporation CurrentSince Dec 13, 2020 Accepting new patients

Locations

72855 Fred Waring Dr
Ste C15
Palm Desert, CA 92260
Phone (760) 393-6026

72855 Fred Waring Dr
Ste C17
Palm Desert, CA 92260
Phone (760) 561-5459

Organizations & group practices 2

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": "1187654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460073600000",
    "number": "1952594103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72855 FRED WARING DR",
            "address_2": "SUITE C17",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922609368",
            "telephone_number": "760-561-5459",
            "fax_number": "760-670-3292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72855 FRED WARING DR STE C17",
            "address_2": "SUITE C17",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922609372",
            "telephone_number": "760-561-5459",
            "fax_number": "760-670-3292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURO",
        "first_name": "EMILIO",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-21",
        "last_updated": "2016-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.