Active NPI
Irina V Ganzha, D.D.S
- Dentist
- San Jose, CA
National Provider Identifier
1043427016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49523
- Practice address
- 1902 N Capitol Ave
Suite # 1
San Jose, CA 95132-1016 - Phone
- (408) 719-8600
- Fax
- (408) 719-8609
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 49523 | CA | Primary |
Addresses
Primary practice location
1902 N Capitol Ave
Suite # 1
San Jose, CA 95132-1016
Mailing address
1902 N Capitol Ave
Suite # 1
San Jose, CA 95132-1016
Phone (408) 719-8600
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 |
|---|---|---|---|
| 49523 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231977600000",
"number": "1043427016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1902 N CAPITOL AVE",
"address_2": "SUITE # 1",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951321016",
"telephone_number": "408-719-8600",
"fax_number": "408-719-8609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1902 N CAPITOL AVE",
"address_2": "SUITE # 1",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951321016",
"telephone_number": "408-719-8600",
"fax_number": "408-719-8609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANZHA",
"first_name": "IRINA",
"middle_name": "V",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2009-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.