Individual provider Active NPI

Stephanie Alarcon

  • Oral and Maxillofacial Surgery (Dentist)
  • Richmond, CA
National Provider Identifier
1053954156
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
104359 Issued in CA
Practice address
315 40TH St
Richmond, CA 94805-2217
Phone
(510) 232-4003
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104359 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 104359 CA Primary

Addresses

Primary practice location

315 40TH St
Richmond, CA 94805-2217

Mailing address

315 40TH St
Richmond, CA 94805-2217
Phone (510) 232-4003

Other practice location 1

19682 Hesperian Blvd Ste 106
Hayward, CA 94541-4752
Phone (510) 264-1410

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
I20220314000797 CA Practitioner - Oral Surgery 8022403807 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
104359CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maria T Alarcon DDS Dental Corporation CurrentSince Jan 1, 2022 Accepting new patients
Maria T Alarcon DDS Dental Corporation CurrentSince Jan 19, 2020 Accepting new patients
Dr. Jiachang Zhang, Inc. Oral and Maxillofacial Surgery Past Accepting new patients

Locations

19682 Hesperian Blvd
Ste 2
Hayward Acres, CA 94541
Phone (510) 253-2350

19682 Hesperian Blvd
Ste 106
Hayward Acres, CA 94541
Phone (510) 252-4003

19682 Hesperian Blvd
Hayward Acres, CA 94541
Phone (510) 253-2350

19682 Hesperian Blvd
Ste 208
Hayward Acres, CA 94541
Phone (510) 253-2350

315 40th St
Richmond, CA 94805
Phone (510) 232-4003

3927 Macdonald Ave
Richmond, CA 94805
Phone (510) 232-4003

Organizations & group practices 3

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": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1053954156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 40TH ST",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948052217",
            "telephone_number": "510-232-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 40TH ST",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948052217",
            "telephone_number": "510-232-4003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19682 Hesperian Blvd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Hayward",
            "state": "CA",
            "postal_code": "945414752",
            "country_code": "US",
            "telephone_number": "510-264-1410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALARCON",
        "first_name": "STEPHANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104359",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "104359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, CA

Sources for this page

Verify at the official NPI Registry.