Individual provider Active NPI

Hamid Reza Nasr, D.D.S

  • General Practice Dentistry
  • Folsom, CA
National Provider Identifier
1023176195
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45298 Issued in CA
Practice address
1625 Creekside Dr
Suite 100
Folsom, CA 95630-3819
Phone
(916) 983-8777
Fax
(916) 983-2096
NPI assigned
Dec 4, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 45298 CA Primary

Addresses

Primary practice location

1625 Creekside Dr
Suite 100
Folsom, CA 95630-3819

Mailing address

PO Box 6535
Folsom, CA 95763-6535
Phone (916) 983-8777

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023176195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6535",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "957636535",
            "telephone_number": "916-983-8777",
            "fax_number": "916-983-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 CREEKSIDE DR",
            "address_2": "SUITE 100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303819",
            "telephone_number": "916-983-8777",
            "fax_number": "916-983-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASR",
        "first_name": "HAMID",
        "middle_name": "REZA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, 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.