Individual provider Active NPI

Mikhail Nasakin, D.D.S.

  • Dentist
  • Palo Alto, CA
National Provider Identifier
1255643367
Registry record updated Feb 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
62159 Issued in CA
Practice address
2421 Park Blvd
Suite A200
Palo Alto, CA 94306-1998
Phone
(650) 325-2457
NPI assigned
Jul 6, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 62159 CA Primary

Addresses

Primary practice location

2421 Park Blvd
Suite A200
Palo Alto, CA 94306-1998

Mailing address

2421 Park Blvd
Suite A200
Palo Alto, CA 94306-1998
Phone (650) 325-2457

Other names 1

  • Dr. Michael Nasakin 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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
62159CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1278374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360195200000",
    "number": "1255643367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 PARK BLVD",
            "address_2": "SUITE A200",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061998",
            "telephone_number": "650-325-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 PARK BLVD",
            "address_2": "SUITE A200",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943061998",
            "telephone_number": "650-325-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASAKIN",
        "first_name": "MIKHAIL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-06",
        "last_updated": "2013-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "NASAKIN",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Palo Alto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2013; 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.