Daniel G Mazza, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

39044 Issued in CA

Practice address

604 Railroad Ave
Winters, CA 95694-1729

Phone

(530) 795-2222

Fax

(530) 795-2221

NPI assigned

Aug 31, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972614527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 RAILROAD AVE",
            "city": "WINTERS",
            "state": "CA",
            "postal_code": "956941729",
            "telephone_number": "530-795-2222",
            "fax_number": "530-795-2221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 RAILROAD AVE",
            "city": "WINTERS",
            "state": "CA",
            "postal_code": "956941729",
            "telephone_number": "530-795-2222",
            "fax_number": "530-795-2221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "DANIEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "39044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTICAL",
            "identifier": "B3904401",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Lakoma
• Jaime Lopez, P.A.
• Jesus Javier Luna, PH.D.
• Candace Holly Mack, OTR/L
• Euphemia Matondo
• Katie Medina Diaz
• Holly Lynn Moen, CNM
• Esteban Montano, AMFT
• Leah Parker
• Megan Rose Pearce

• General Practice Dentistry in Winters, CA
• Providers in Winters, CA by specialty
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.