Individual provider Active NPI

Yasamin Sariaslani, D.D.S

  • Dentist
  • Santa Rosa, CA
National Provider Identifier
1316234842
Registry record updated Nov 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
60466 Issued in CA
Practice address
4100 Montgomery Dr
Ste. a
Santa Rosa, CA 95405-5282
Phone
(707) 537-2020
NPI assigned
Jul 5, 2011
Last updated
Nov 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 60466 CA Primary

Addresses

Primary practice location

4100 Montgomery Dr
Ste. a
Santa Rosa, CA 95405-5282

Mailing address

11299 San Pablo Ave
Suite a
El Cerrito, CA 94530-2184
Phone (415) 430-7383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171127002362 CA Order and Referring Only - DentistPractitioner - Dentist 2769749928

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Interoperability endpoints

  • Direct secure messaging: ysariaslani@direct.westerndental.com

NPI Registry JSON

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446681600000",
    "number": "1316234842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11299 SAN PABLO AVE",
            "address_2": "SUITE A",
            "city": "EL CERRITO",
            "state": "CA",
            "postal_code": "945302184",
            "telephone_number": "415-430-7383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MONTGOMERY DR",
            "address_2": "STE. A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055282",
            "telephone_number": "707-537-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARIASLANI",
        "first_name": "YASAMIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-05",
        "last_updated": "2015-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "60466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.