Farhad Kandakloo, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

41626 Issued in CA

Practice address

1586 Gateway Blvd Ste C1
Fairfield, CA 94533-6911

Phone

(925) 426-1234

NPI assigned

Nov 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312502400000",
    "number": "1154497949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CLAREMONT CREST CT",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831298",
            "telephone_number": "925-208-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1586 GATEWAY BLVD STE C1",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336911",
            "telephone_number": "925-426-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANDAKLOO",
        "first_name": "FARHAD",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-26",
        "last_updated": "2011-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Mary Judson, PT
• Israel Ramirez Jurado, RD
• Kristin Jusinski, R.N.
• Kaiser Foundation Health Plan Inc (Kaiser Health Plan Mob Phy 401)
• Amadu Bubass Kamara
• Nikhita Kandikuppa Sharma
• Kang, Hyo S. DMD Inc. (Wellspring Dental Group)
• Albert Deh-Zen Kao, PHARM.D.
• Yi Kao
• Krunali Kapadia

• Dentist in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.

Verify at the official NPI Registry.