Organization Active NPI

Sandeep Potdar, DDS, Inc

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1083331185
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SANDEEP POTDAR, DDS, INC
Practice address
1720 Hamilton Ave
San Jose, CA 95125-5424
Phone
(786) 280-1288
NPI assigned
Oct 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Sandeep P Potdar, DDSNPI 1346508355
Title
General Dentist
Phone
(786) 280-1288

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

1720 Hamilton Ave
San Jose, CA 95125-5424

Mailing address

1720 Hamilton Ave
San Jose, CA 95125-5424
Phone (786) 280-1288

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1083331185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 HAMILTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255424",
            "telephone_number": "786-280-1288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 HAMILTON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951255424",
            "telephone_number": "786-280-1288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDEEP POTDAR, DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-19",
        "status": "A",
        "authorized_official_last_name": "POTDAR",
        "authorized_official_first_name": "SANDEEP",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "786-280-1288",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "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 Oct 20, 2022; 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.