MEDICARE: DR. FILIPPO CANGINI DDS, MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	60373	CA
2	122300000X	Dentist	053389	NY
3	1223P0300X	Periodontics	60373	CA

General Provider Information

NPI Number	:	1205049137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FILIPPO CANGINI DDS, MS

Provider Business Mailing Address
First Line	:	1371 SUNSET LOOP
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-6000
Country	:	US
Telephone Number	:	925-956-2032
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 SUNSET LOOP
Second Line	:
City	:	LAFAYETTE
State	:	CA
Zip	:	94549-6000
Country	:	US
Telephone Number	:	925-956-2032
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/22/2024

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