Active NPI
Clara Nancy Andirious, D.D.S.
- Dentist
- San Jose, CA
National Provider Identifier
1053472365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 51545
- Practice address
- 6472 Camden Ave.
Suite 100
San Jose, CA 95120 - Phone
- (408) 997-9027
- Fax
- (408) 997-7852
- NPI assigned
- Dec 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 51545 | CA | |
| Dentist | 122300000X | 51545 | CA | Primary |
Addresses
Primary practice location
6472 Camden Ave.
Suite 100
San Jose, CA 95120
Mailing address
6472 Camden Ave.
Suite 100
San Jose, CA 95120
Phone (408) 997-9027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G93394-01 | Medicaid | CA |
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 |
|---|---|---|---|
| 51545 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454025600000",
"number": "1053472365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6472 CAMDEN AVE.",
"address_2": "SUITE 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95120",
"telephone_number": "408-997-9027",
"fax_number": "408-997-7852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6472 CAMDEN AVE.",
"address_2": "SUITE 100",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "95120",
"telephone_number": "408-997-9027",
"fax_number": "408-997-7852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDIRIOUS",
"first_name": "CLARA",
"middle_name": "NANCY",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-12",
"last_updated": "2016-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "51545",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51545",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G93394-01",
"state": "CA"
}
],
"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 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.