Individual provider Active NPI

Ling Elena Ralli, D.D.S.

  • General Practice Dentistry
  • Roseville, CA
National Provider Identifier
1053439539
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47828 Issued in CA
Practice address
7456 Foothills Blvd
Suite 14
Roseville, CA 95747-6560
Phone
(916) 773-0800
Fax
(916) 773-0835
NPI assigned
Mar 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

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 47828 CA Primary

Addresses

Primary practice location

7456 Foothills Blvd
Suite 14
Roseville, CA 95747-6560

Mailing address

7456 Foothills Blvd
Suite 14
Roseville, CA 95747-6560
Phone (916) 773-0800

Other names 1

  • Ling Elena Xiao Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201109001440 CA Practitioner - Dentist 4587960190 Practice locations: Roseville, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47828CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Woodcreek Dentistry Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053439539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7456 FOOTHILLS BLVD",
            "address_2": "SUITE 14",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476560",
            "telephone_number": "916-773-0800",
            "fax_number": "916-773-0835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7456 FOOTHILLS BLVD",
            "address_2": "SUITE 14",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476560",
            "telephone_number": "916-773-0800",
            "fax_number": "916-773-0835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RALLI",
        "first_name": "LING",
        "middle_name": "ELENA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LING",
            "last_name": "XIAO",
            "middle_name": "ELENA",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.