Individual provider Active NPI

Imran A Rizvi, DDS

  • Dentist
  • Tracy, CA
National Provider Identifier
1013036177
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
44997 Issued in CA
Practice address
1837 W 11TH St
Tracy, CA 95376-3727
Phone
(209) 834-2990
Fax
(209) 834-2986
NPI assigned
Mar 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 44997 CA Primary

Addresses

Primary practice location

1837 W 11TH St
Tracy, CA 95376-3727

Mailing address

1837 W 11TH St
Tracy, CA 95376-3727
Phone (209) 834-2990

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

LicenseStateTypeSpecialty
44997CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013036177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1837 W 11TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763727",
            "telephone_number": "209-834-2990",
            "fax_number": "209-834-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1837 W 11TH ST",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763727",
            "telephone_number": "209-834-2990",
            "fax_number": "209-834-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZVI",
        "first_name": "IMRAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "44997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.