Active NPI
Adeena Mohtashim
- General Practice Dentistry
- Pleasanton, CA
National Provider Identifier
1235917022
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS109240
- Practice address
- 5890 Stoneridge Dr Ste 108
Pleasanton, CA 94588-5825 - Phone
- (702) 927-5194
- NPI assigned
- Sep 21, 2023
- 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 | DDS109240 | CA | Primary |
Addresses
Primary practice location
5890 Stoneridge Dr Ste 108
Pleasanton, CA 94588-5825
Mailing address
40890 Marty Ter
Fremont, CA 94539-4459
Phone (702) 927-5194
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 |
|---|---|---|---|
| DDS109240 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695254400000",
"number": "1235917022",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40890 MARTY TER",
"city": "FREMONT",
"state": "CA",
"postal_code": "945394459",
"telephone_number": "702-927-5194"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5890 STONERIDGE DR STE 108",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945885825",
"telephone_number": "702-927-5194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOHTASHIM",
"first_name": "ADEENA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-21",
"last_updated": "2023-09-21",
"certification_date": "2023-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "DDS109240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.