Active NPI
Gila C Dorostkar, D.D.S.
- Pediatric Dentistry
- Greenbrae, CA
National Provider Identifier
1164549044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 39147
- Practice address
- 1321 S Eliseo Dr
Greenbrae, CA 94904-2024 - Phone
- (415) 461-0414
- Fax
- (415) 461-0431
- NPI assigned
- Mar 23, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 39147 | CA | Primary |
Addresses
Primary practice location
1321 S Eliseo Dr
Greenbrae, CA 94904-2024
Mailing address
1321 S Eliseo Dr
Greenbrae, CA 94904-2024
Phone (415) 461-0414
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
| License | State | Type | Specialty |
|---|---|---|---|
| 39147 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174608000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164549044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1321 S ELISEO DR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042024",
"telephone_number": "415-461-0414",
"fax_number": "415-461-0431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1321 S ELISEO DR",
"city": "GREENBRAE",
"state": "CA",
"postal_code": "949042024",
"telephone_number": "415-461-0414",
"fax_number": "415-461-0431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOROSTKAR",
"first_name": "GILA",
"middle_name": "C",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "39147",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenbrae, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.