Individual provider Active NPI

Sanjana Ravindra

  • General Practice Dentistry
  • Madera, CA
National Provider Identifier
1306622915
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109719 Issued in CA
Practice address
705 W Pecan Ave
Madera, CA 93637-6254
Phone
(559) 664-4000
NPI assigned
Sep 7, 2023
Last updated
Sep 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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 109719 CA Primary
General Practice Dentistry 1223G0001X 019.034617 IL

Addresses

Primary practice location

705 W Pecan Ave
Madera, CA 93637-6254

Mailing address

263 N Amedeo LN
Clovis, CA 93611-6177
Phone (415) 967-8641

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
019.034617ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Camarena Health CurrentSince Sep 10, 2023 Accepting new patients

Locations

750 E Almond Ave
Madera, CA 93637

Interoperability endpoints

  • Direct secure messaging: sanjana.ravindra.1@25900.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1306622915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 N AMEDEO LN",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116177",
            "telephone_number": "415-967-8641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W PECAN AVE",
            "city": "MADERA",
            "state": "CA",
            "postal_code": "936376254",
            "telephone_number": "559-664-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINDRA",
        "first_name": "SANJANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-07",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109719",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.034617",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madera, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.