Individual provider Active NPI

Angel Javier Pinto, D.D.S.

  • Dentist
  • Sacramento, CA
National Provider Identifier
1972703122
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52103 Issued in CA
Practice address
925 Secret River Dr Ste J
Sacramento, CA 95831-3465
Phone
(916) 594-9474
Fax
(916) 594-9146
NPI assigned
Jul 24, 2007
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52103 CA Primary

Addresses

Primary practice location

925 Secret River Dr Ste J
Sacramento, CA 95831-3465

Mailing address

8942 Criollo CT
Elk Grove, CA 95757-3292
Phone (831) 207-5072

Other practice location 1

204 E Beach St
Watsonville, CA 95076-4809
Phone (831) 763-3413

Other practice location 2

8942 Criollo Ct
Elk Grove, CA 95757-3292
Phone (831) 207-5072

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
I20120810000121 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3779748199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52103CAMDPharmacist

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": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972703122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8942 CRIOLLO CT",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957573292",
            "telephone_number": "831-207-5072",
            "fax_number": "916-594-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 SECRET RIVER DR STE J",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313465",
            "telephone_number": "916-594-9474",
            "fax_number": "916-594-9146"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 E Beach St",
            "address_purpose": "LOCATION",
            "city": "Watsonville",
            "state": "CA",
            "postal_code": "950764809",
            "country_code": "US",
            "telephone_number": "831-763-3413",
            "fax_number": "831-728-8257",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8942 Criollo Ct",
            "address_purpose": "LOCATION",
            "city": "Elk Grove",
            "state": "CA",
            "postal_code": "957573292",
            "country_code": "US",
            "telephone_number": "831-207-5072",
            "fax_number": "916-594-9146",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PINTO",
        "first_name": "ANGEL",
        "middle_name": "JAVIER",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-24",
        "last_updated": "2023-03-07",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.