Active NPI
Ali Tahseen Jasim
- Dentist
- Yuba City, CA
National Provider Identifier
1336744093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 105839
- Practice address
- 853 Plumas St
Yuba City, CA 95991-4010 - Phone
- (530) 763-5595
- NPI assigned
- Dec 1, 2020
- 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 | 105839 | CA | Primary |
Addresses
Primary practice location
853 Plumas St
Yuba City, CA 95991-4010
Mailing address
10270 E Taron Dr Apt 230
Elk Grove, CA 95757-8243
Phone (619) 201-5390
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210222000668 | CA | Order and Referring Only - Dentist | 4082029269 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1606780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607040000000",
"number": "1336744093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10270 E TARON DR APT 230",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "957578243",
"telephone_number": "619-201-5390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "853 PLUMAS ST",
"city": "YUBA CITY",
"state": "CA",
"postal_code": "959914010",
"telephone_number": "530-763-5595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JASIM",
"first_name": "ALI",
"middle_name": "TAHSEEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-12-01",
"last_updated": "2020-12-04",
"certification_date": "2020-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "105839",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuba City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.