Organization Active NPI

Niloofar Deyhim DDS Inc

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Modesto, CA
National Provider Identifier
1154834000
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
Legal business name
NILOOFAR DEYHIM DDS INC
Practice address
1316 Coffee Rd Ste E14
Modesto, CA 95355-3191
Phone
(209) 522-9963
NPI assigned
Nov 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Authorized official

Name
Niloofar Deyhim, DDSNPI 1407114499
Title
DDS
Phone
(408) 608-8012

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 204E00000X Primary

Addresses

Primary practice location

1316 Coffee Rd Ste E14
Modesto, CA 95355-3191

Mailing address

3550 Alden Way Apt 15
San Jose, CA 95117-1569

National Provider Directory

National Provider Directory

Locations

1316 Coffee Rd
Ste E14
Modesto, CA 95355
Phone (209) 522-9936

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1510617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1154834000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 ALDEN WAY APT 15",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1316 COFFEE RD STE E14",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553191",
            "telephone_number": "209-522-9963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NILOOFAR DEYHIM DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-14",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "DEYHIM",
        "authorized_official_first_name": "NILOOFAR",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "408-608-8012",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.