Active NPI
Sandra Guereca, D.D.S.
- General Practice Dentistry
- Hayward, CA
National Provider Identifier
1225265127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 53794
- Practice address
- 24901 Santa Clara St
Ste B2
Hayward, CA 94544-2147 - Phone
- (510) 887-6835
- Fax
- (510) 887-2872
- NPI assigned
- Jun 17, 2009
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 53794 | CA | Primary |
Addresses
Primary practice location
24901 Santa Clara St
Ste B2
Hayward, CA 94544-2147
Mailing address
23630 Carlson CT
Hayward, CA 94541-4583
Phone (510) 728-9842
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 |
|---|---|---|---|
| 53794 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jaime V. Evangelista Jr, D.M.D, Inc. | General Practice | Past | 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.
-
- General Practice Dentistry
- Hayward, CA
- NPI 1851476766
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1245196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258329600000",
"number": "1225265127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23630 CARLSON CT",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945414583",
"telephone_number": "510-728-9842",
"fax_number": "510-887-2872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24901 SANTA CLARA ST",
"address_2": "STE B2",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945442147",
"telephone_number": "510-887-6835",
"fax_number": "510-887-2872"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUERECA",
"first_name": "SANDRA",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-06-17",
"last_updated": "2009-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "53794",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.