Individual provider Active NPI

Gregory George Ganji, DDS

  • General Practice Dentistry
  • Santa Clara, CA
National Provider Identifier
1174731772
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48910 Issued in CA
Practice address
122 Saratoga Ave
Santa Clara, CA 95051-7385
Phone
(408) 556-1333
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 48910 CA Primary

Addresses

Primary practice location

122 Saratoga Ave
Santa Clara, CA 95051-7385

Mailing address

164 Westhill Dr
Los Gatos, CA 95032-5021
Phone (415) 310-7357

Other practice location 1

450 Sutter St
Suite 2500
San Francisco, CA 94108-4206
Phone (415) 989-3953

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190404002737 CA Practitioner - Oral Surgery 3173815909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suman Ramakumar DDS Inc General Practice PastSince Aug 11, 2019 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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1174731772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WESTHILL DR",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950325021",
            "telephone_number": "415-310-7357",
            "fax_number": "415-310-7357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 SARATOGA AVE",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950517385",
            "telephone_number": "408-556-1333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450 Sutter St",
            "address_2": "Suite 2500",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941084206",
            "country_code": "US",
            "telephone_number": "415-989-3953",
            "fax_number": "415-989-7349",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GANJI",
        "first_name": "GREGORY",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.