Active NPI
Shadi Javadi
- Dentist
- Elk Grove, CA
National Provider Identifier
1134655715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 65031
- Practice address
- 9700 West Taron Drive
California Northstate University
Elk Grove, CA 95757 - Phone
- (916) 686-7300
- NPI assigned
- May 3, 2017
- Last updated
- Mar 5, 2022
- 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 | 65031 | CA | Primary |
Addresses
Primary practice location
9700 West Taron Drive
California Northstate University
Elk Grove, CA 95757
Mailing address
731 16TH Street
Apt 210
Sacramento, CA 95814
Phone (347) 882-6436
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 |
|---|---|---|---|
| Hoang and Rho Dental Corporation | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Park Place Dental Group
- General Practice Dentistry
- Sacramento, CA
- NPI 1326133190
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646438400000",
"number": "1134655715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "731 16TH STREET",
"address_2": "APT 210",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95814",
"telephone_number": "347-882-6436"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9700 WEST TARON DRIVE",
"address_2": "CALIFORNIA NORTHSTATE UNIVERSITY",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "95757",
"telephone_number": "916-686-7300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAVADI",
"first_name": "SHADI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-03",
"last_updated": "2022-03-05",
"certification_date": "2022-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "65031",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk Grove, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.