Active NPI
Fina Yvette Madrid, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1962762716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 61317
- Practice address
- 4060 Fairmount Ave
San Diego, CA 92105-1608 - Phone
- (619) 280-4213
- NPI assigned
- May 25, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 61317 | CA | Primary |
Addresses
Primary practice location
4060 Fairmount Ave
San Diego, CA 92105-1608
Mailing address
4060 Fairmount Ave
San Diego, CA 92105-1608
Phone (619) 280-4213
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160712001448 | CA | Order and Referring Only - Oral Surgery | 2062704026 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1337904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1387411200000",
"number": "1962762716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4060 FAIRMOUNT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921051608",
"telephone_number": "619-280-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4060 FAIRMOUNT AVE",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921051608",
"telephone_number": "619-280-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADRID",
"first_name": "FINA",
"middle_name": "YVETTE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-05-25",
"last_updated": "2013-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "61317",
"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 Dec 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.