Active NPI
Jayasree Mettu, DDS
- Dentist
- Danville, CA
National Provider Identifier
1073795621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47954
- Practice address
- 709 Sweet Water Dr
Danville, CA 94506-1225 - Phone
- (573) 680-7525
- NPI assigned
- Dec 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 47954 | CA | Primary |
| Public Health Dentistry | 1223D0001X | 47954 | CA |
Addresses
Primary practice location
709 Sweet Water Dr
Danville, CA 94506-1225
Mailing address
709 Sweet Water Dr
Danville, CA 94506-1225
Phone (573) 680-7525
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 |
|---|---|---|---|
| 47954 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1073795621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 SWEET WATER DR",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945061225",
"telephone_number": "573-680-7525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 SWEET WATER DR",
"city": "DANVILLE",
"state": "CA",
"postal_code": "945061225",
"telephone_number": "573-680-7525"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METTU",
"first_name": "JAYASREE",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-12-05",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47954",
"primary": true
},
{
"code": "1223D0001X",
"taxonomy_group": "",
"desc": "Dentist, Dental Public Health",
"state": "CA",
"license": "47954",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.