Individual provider Active NPI

Sadi N Kermani, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rohnert Park, CA
National Provider Identifier
1043401078
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
51482 Issued in CA
Practice address
1331 Medical Center Dr Ste F
Rohnert Park, CA 94928-2900
Phone
(707) 852-1662
Fax
(707) 755-3895
NPI assigned
Aug 6, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 51482 CA Primary

Addresses

Primary practice location

1331 Medical Center Dr Ste F
Rohnert Park, CA 94928-2900

Mailing address

1331 Medical Center Dr Ste F
Rohnert Park, CA 94928-2900
Phone (707) 852-1662

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sadi Kermani DDS PC Inc Orthodontics and Dentofacial Orthopedics CurrentSince Feb 11, 2024 Accepting new patients

Locations

1331 Medical Center Dr
Ste F
Rohnert Park, CA 94928
Phone (707) 584-7755

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707264000000",
    "number": "1043401078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1331 MEDICAL CENTER DR STE F",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282900",
            "telephone_number": "707-852-1662",
            "fax_number": "707-755-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 MEDICAL CENTER DR STE F",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949282900",
            "telephone_number": "707-852-1662",
            "fax_number": "707-755-3895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERMANI",
        "first_name": "SADI",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-06",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "51482",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.

Verify at the official NPI Registry.