Individual provider Active NPI

Isabella Shtulman Soloveychik, D.D.S.

  • General Practice Dentistry
  • Hayward, CA
National Provider Identifier
1255463154
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42228 Issued in CA
Practice address
19682 Hesperian Blvd
Suite 101
Hayward, CA 94541-4752
Phone
(510) 782-9942
Fax
(800) 668-9530
NPI assigned
Mar 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 42228 CA Primary

Addresses

Primary practice location

19682 Hesperian Blvd
Suite 101
Hayward, CA 94541-4752

Mailing address

5300 Cypress Hawk CT
San Ramon, CA 94582-5009
Phone (925) 968-9004

Other identifiers 3

IdentifierTypeStateIssuer
000000007377OtherCAPACIFICARE DENTAL
B42228-01MedicaidCA
000000003937OtherCAUNITEDHEALTHCARE

Other names 1

  • Isabella Shtulman -Soloveychik Other name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
42228CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1255463154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 CYPRESS HAWK CT",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825009",
            "telephone_number": "925-968-9004",
            "fax_number": "510-782-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19682 HESPERIAN BLVD",
            "address_2": "SUITE 101",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945414752",
            "telephone_number": "510-782-9942",
            "fax_number": "800-668-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOVEYCHIK",
        "first_name": "ISABELLA",
        "middle_name": "SHTULMAN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42228",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE DENTAL",
            "identifier": "000000007377",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B42228-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "000000003937",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ISABELLA",
            "last_name": "SHTULMAN -SOLOVEYCHIK",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Jul 9, 2007; 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.