Individual provider Active NPI

Krunali Kapadia

  • General Practice Dentistry
  • Fairfield, CA
National Provider Identifier
1063063469
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104366 Issued in CA
Practice address
1325 Travis Blvd Ste D
Fairfield, CA 94533-4611
Phone
(707) 427-2222
NPI assigned
Sep 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 104366 CA Primary

Addresses

Primary practice location

1325 Travis Blvd Ste D
Fairfield, CA 94533-4611

Mailing address

1209 Sassone CT
Milpitas, CA 95035-7000

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

LicenseStateTypeSpecialty
104366CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chen & Su Dental Group, Inc. General Practice CurrentSince Apr 10, 2022 Accepting new patients

Locations

1325 Travis Blvd
Ste D
Fairfield, CA 94533
Phone (707) 427-2222

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": "1569456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1063063469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 SASSONE CT",
            "city": "MILPITAS",
            "state": "CA",
            "postal_code": "950357000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 TRAVIS BLVD STE D",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945334611",
            "telephone_number": "707-427-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPADIA",
        "first_name": "KRUNALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-26",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.