Active NPI
Todd Matthew Yerondopoulos
- Dentist
- Pleasanton, CA
National Provider Identifier
1326145285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 43880
- Practice address
- 4713 1St St
Suite 155
Pleasanton, CA 94566-7361 - Phone
- (925) 931-9100
- Fax
- (408) 730-8662
- NPI assigned
- Sep 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 43880 | CA | Primary |
Addresses
Primary practice location
4713 1St St
Suite 155
Pleasanton, CA 94566-7361
Mailing address
4713 1St St
Suite 155
Pleasanton, CA 94566-7361
Phone (925) 931-9100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 43880 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225238400000",
"number": "1326145285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4713 1ST ST",
"address_2": "SUITE 155",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945667361",
"telephone_number": "925-931-9100",
"fax_number": "408-730-8662"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4713 1ST ST",
"address_2": "SUITE 155",
"city": "PLEASANTON",
"state": "CA",
"postal_code": "945667361",
"telephone_number": "925-931-9100",
"fax_number": "408-730-8662"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YERONDOPOULOS",
"first_name": "TODD",
"middle_name": "MATTHEW",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-20",
"last_updated": "2008-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "43880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasanton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.