Individual provider Active NPI

Hellene Eleni Ellenikiotis, DDS, MS

  • Pediatric Dentistry
  • Saratoga, CA
National Provider Identifier
1285087080
Registry record updated Feb 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
100406 Issued in CA
Practice address
20514 Saratoga Los Gatos Rd Ste a
Saratoga, CA 95070-5970
Phone
(408) 872-1900
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 100406 CA
Pediatric Dentistry 1223P0221X 100406 CA Primary

Addresses

Primary practice location

20514 Saratoga Los Gatos Rd Ste a
Saratoga, CA 95070-5970

Mailing address

20514 Saratoga Los Gatos Rd Ste a
Saratoga, CA 95070-5970
Phone (408) 872-1900

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
100406CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mamal R. Rahimi, D.D.S. Inc. General Practice PastSince Jan 17, 2022 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.

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675555200000",
    "number": "1285087080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20514 SARATOGA LOS GATOS RD STE A",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705970",
            "telephone_number": "408-872-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20514 SARATOGA LOS GATOS RD STE A",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705970",
            "telephone_number": "408-872-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENIKIOTIS",
        "first_name": "HELLENE",
        "middle_name": "ELENI",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2023-02-05",
        "certification_date": "2023-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "100406",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "100406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.

Verify at the official NPI Registry.