Active NPI
Farideh Hakimi, DMD
- Dentist
- San Rafael, CA
National Provider Identifier
1083816292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 47085
- Practice address
- 920 Northgate Dr
Suite 3
San Rafael, CA 94903 - Phone
- (415) 479-4640
- NPI assigned
- Jun 1, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 47085 | CA | Primary |
Addresses
Primary practice location
920 Northgate Dr
Suite 3
San Rafael, CA 94903
Mailing address
920 Northgate Dr
Suite 3
San Rafael, CA 94903
Phone (415) 479-4640
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170105002120 | CA | Order and Referring Only - Dentist | 5496036485 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1083816292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "920 NORTHGATE DR",
"address_2": "SUITE 3",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-479-4640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 NORTHGATE DR",
"address_2": "SUITE 3",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-479-4640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAKIMI",
"first_name": "FARIDEH",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "47085",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.