Individual provider Active NPI

Ardeshir N. Salem, DDS

  • Dentist
  • Los Altos, CA
National Provider Identifier
1194989640
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
36830 Issued in CA
Practice address
925 N San Antonio Rd
Los Altos, CA 94022-1308
Phone
(650) 559-0000
NPI assigned
Jul 14, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 36830 CA Primary

Addresses

Primary practice location

925 N San Antonio Rd
Los Altos, CA 94022-1308

Mailing address

925 N San Antonio Rd
Los Altos, CA 94022-1308
Phone (650) 559-0000

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
I20190514002624 CA Practitioner - Dentist 8224371216 Practice locations: Los Altos, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
36830CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1215993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1194989640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 N SAN ANTONIO RD",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221308",
            "telephone_number": "650-559-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 N SAN ANTONIO RD",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221308",
            "telephone_number": "650-559-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALEM",
        "first_name": "ARDESHIR",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "36830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

Verify at the official NPI Registry.