NPIMap

Organization Active NPI

Hedayati Koo Adc

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1215008925
Registry record updated Feb 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36376 Issued in CA
Legal business name
HEDAYATI KOO ADC
Practice address
827 Blossom Hill Rd Ste E8
San Jose, CA 95123-2701
Phone
(408) 578-4700
Fax
(408) 578-5730
NPI assigned
Nov 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2015

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

Authorized official

Name
Shirin HedayatiNPI 1740673102
Title
Dentist
Phone
(408) 578-4700

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 36376 CA Primary

Addresses

Primary practice location

827 Blossom Hill Rd Ste E8
San Jose, CA 95123-2701

Mailing address

827 Blossom Hill Rd Ste E8
San Jose, CA 95123-2701
Phone (408) 578-4700

National Provider Directory

National Provider Directory

Locations

827 Blossom Hill Rd
Ste E8
San Jose, CA 95123
Phone (408) 578-4700

Practitioners & affiliated clinicians

Practitioners 2

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": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423785600000",
    "number": "1215008925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD STE E8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-578-4700",
            "fax_number": "408-578-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 BLOSSOM HILL RD STE E8",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951232701",
            "telephone_number": "408-578-4700",
            "fax_number": "408-578-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEDAYATI KOO ADC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-02-13",
        "status": "A",
        "authorized_official_last_name": "HEDAYATI",
        "authorized_official_first_name": "SHIRIN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "408-578-4700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2015; 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.