Individual provider Active NPI

Andrea Barcelos Azevedo, D.D.S.

  • General Practice Dentistry
  • Sacramento, CA
National Provider Identifier
1194948083
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
48785 Issued in CA
Practice address
1809 S St
Suite 101-157
Sacramento, CA 95811-6736
Phone
(916) 284-1170
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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 48785 CA Primary

Addresses

Primary practice location

1809 S St
Suite 101-157
Sacramento, CA 95811-6736

Mailing address

1809 S St
Suite 101-157
Sacramento, CA 95811-6736

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
48785CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1194948083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 S ST",
            "address_2": "SUITE 101-157",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958116736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 S ST",
            "address_2": "SUITE 101-157",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958116736",
            "telephone_number": "916-284-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZEVEDO",
        "first_name": "ANDREA",
        "middle_name": "BARCELOS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-10",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "48785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.