Active NPI
Shahnaz L Formoli, DDS
- General Practice Dentistry
- Sacramento, CA
National Provider Identifier
1134316706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 43149
- Practice address
- 4360 Arden Way
#3
Sacramento, CA 95864-3153 - Phone
- (916) 485-4800
- Fax
- (916) 483-4806
- NPI assigned
- Sep 27, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 43149 | CA | Primary |
Addresses
Primary practice location
4360 Arden Way
#3
Sacramento, CA 95864-3153
Mailing address
4360 Arden Way
#3
Sacramento, CA 95864-3153
Phone (916) 485-4800
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Formoli Dental Practices Inc | Current | Accepting new patients |
Locations
4360 Arden Way
Ste 3
Sacramento, CA 95864
Phone (916) 485-4800
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": "1190851200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190851200000",
"number": "1134316706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4360 ARDEN WAY",
"address_2": "#3",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958643153",
"telephone_number": "916-485-4800",
"fax_number": "916-483-4806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4360 ARDEN WAY",
"address_2": "#3",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958643153",
"telephone_number": "916-485-4800",
"fax_number": "916-483-4806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORMOLI",
"first_name": "SHAHNAZ",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-27",
"last_updated": "2007-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "43149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.