Axelrode Professional Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

AXELRODE PROFESSIONAL CORPORATION

Doing business as

Axelrode Orthodontics

Practice address

2000 Appian Way Ste 301
Pinole, CA 94564-2525

Phone

(510) 724-8855

Fax

(510) 724-8861

NPI assigned

Jul 8, 2024

Organization subpart

No

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

Authorized official

Name

Yasmine Karavattuveetil

Title

RCM Director

Phone

(630) 936-8137

Specialties & licenses 1

Addresses

Other names 1

• Axelrode Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mark Axelrode, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Pinole, CA
  • NPI 1215055819
  NPD (past)

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720396800000",
    "number": "1154167229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 APPIAN WAY STE 301",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642525",
            "telephone_number": "510-724-8855",
            "fax_number": "510-724-8861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXELRODE PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A",
        "authorized_official_last_name": "KARAVATTUVEETIL",
        "authorized_official_first_name": "YASMINE",
        "authorized_official_title_or_position": "RCM DIRECTOR",
        "authorized_official_telephone_number": "630-936-8137"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axelrode Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Appian Medical GP
• Patricia Arana
• Connor Leon Archer, D.C.
• Kay Arciaga
• Caleb Abeku Arthur, MD
• Mark Axelrode, DDS
• Azadeh Hosseini DDS Inc
• Daniel Eduardo Badias Castillo
• Behnoosh Bahrami
• Paula Baluyot

• Orthodontics and Dentofacial Orthopedics Dentistry in Pinole, CA
• Providers in Pinole, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; 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.