Active NPI
Shivanesh Naicker, DMD
- Dentist
- San Francisco, CA
National Provider Identifier
1003664426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110062
- Practice address
- 450 Sutter St RM 808
San Francisco, CA 94108-3910 - Phone
- (415) 513-5066
- NPI assigned
- May 9, 2024
- Sex
- Male
- 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 | 110062 | CA | Primary |
Addresses
Primary practice location
450 Sutter St RM 808
San Francisco, CA 94108-3910
Mailing address
657 Spruce Ave
South San Francisco, CA 94080-2751
Phone (650) 922-8418
Other practice location 1
290 King St Unit 8
San Francisco, CA 94107-6440
Phone (415) 618-0890
Other practice location 2
1133 El Camino Real Ste 5
South San Francisco, CA 94080-3288
Phone (650) 244-9928
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 110062 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Darren D Wong DDS Inc | Dentist | Past | Accepting new patients |
| Pure Smile Dental Group | Past | Accepting new patients | |
| Mina Levi, DDS, Inc | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Mill Valley, CA
- NPI 1538037809
-
- Dental Clinic/Center
- San Francisco, CA
- NPI 1811492176
-
- Dental Clinic/Center
- South San Francisco, CA
- NPI 1609141274
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1003664426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "657 SPRUCE AVE",
"city": "SOUTH SAN FRANCISCO",
"state": "CA",
"postal_code": "940802751",
"telephone_number": "650-922-8418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 SUTTER ST RM 808",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941083910",
"telephone_number": "415-513-5066"
}
],
"practiceLocations": [
{
"address_1": "290 King St Unit 8",
"address_purpose": "LOCATION",
"city": "San Francisco",
"state": "CA",
"postal_code": "941076440",
"country_code": "US",
"telephone_number": "415-618-0890",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1133 El Camino Real Ste 5",
"address_purpose": "LOCATION",
"city": "South San Francisco",
"state": "CA",
"postal_code": "940803288",
"country_code": "US",
"telephone_number": "650-244-9928",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAICKER",
"first_name": "SHIVANESH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-09",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.