Individual provider Active NPI

Ziba Manouchehrizadeh, DDS

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1073615779
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42935 Issued in CA
Practice address
335 Saratoga Ave Ste 20
San Jose, CA 95129-1325
Phone
(408) 218-3124
Fax
(408) 927-5772
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

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 42935 CA Primary

Addresses

Primary practice location

335 Saratoga Ave Ste 20
San Jose, CA 95129-1325

Mailing address

335 Saratoga Ave Ste 20
San Jose, CA 95129-1325
Phone (408) 218-3124

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

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073615779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 SARATOGA AVE STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951291325",
            "telephone_number": "408-218-3124",
            "fax_number": "408-927-5772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 SARATOGA AVE STE 20",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951291325",
            "telephone_number": "408-218-3124",
            "fax_number": "408-927-5772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANOUCHEHRIZADEH",
        "first_name": "ZIBA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42935",
            "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 Jul 8, 2007; 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.