Individual provider Active NPI

Shital Kazi, D.D.S.

  • Dentist
  • San Lorenzo, CA
National Provider Identifier
1154662922
Registry record updated Mar 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40628 Issued in CA
Practice address
10 Lewelling Blvd
San Lorenzo, CA 94580-1628
Phone
(510) 276-6040
Fax
(501) 315-4886
NPI assigned
Mar 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40628 CA Primary

Addresses

Primary practice location

10 Lewelling Blvd
San Lorenzo, CA 94580-1628

Mailing address

10 Lewelling Blvd
San Lorenzo, CA 94580-1628
Phone (510) 276-6040

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

State licenses

LicenseStateTypeSpecialty
40628CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kazi, Inc. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362355200000",
    "number": "1154662922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LEWELLING BLVD",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945801628",
            "telephone_number": "510-276-6040",
            "fax_number": "501-315-4886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LEWELLING BLVD",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945801628",
            "telephone_number": "510-276-6040",
            "fax_number": "501-315-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAZI",
        "first_name": "SHITAL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-04",
        "last_updated": "2013-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Lorenzo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.