Individual provider Active NPI

Ushma Patadia

  • General Practice Dentistry
  • Tracy, CA
National Provider Identifier
1356089213
Registry record updated Apr 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
109081 Issued in CA
Practice address
2160 W Grant Line Rd Ste 220
Tracy, CA 95377-7333
Phone
(209) 835-8754
NPI assigned
May 21, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 109081 CA Primary

Addresses

Primary practice location

2160 W Grant Line Rd Ste 220
Tracy, CA 95377-7333

Mailing address

739 Alden LN
Livermore, CA 94550-4752
Phone (860) 899-8355

Other practice location 1

79 Retreat Ave # Hartford
Hartford, CT 06106-2527
Phone (860) 927-2700

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
109081CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ushma Patadia, DMD, PC CurrentSince Dec 15, 2024 Accepting new patients
George Shiao, DMD PastSince Apr 21, 2024 Accepting new patients

Locations

87 Fenton St
Ste 105
Livermore, CA 94550
Phone (925) 373-9182

Organizations & group practices 2

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": "1653091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713571200000",
    "number": "1356089213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 ALDEN LN",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504752",
            "telephone_number": "860-899-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 W GRANT LINE RD STE 220",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777333",
            "telephone_number": "209-835-8754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "79 Retreat Ave # Hartford",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061062527",
            "country_code": "US",
            "telephone_number": "860-927-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATADIA",
        "first_name": "USHMA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-21",
        "last_updated": "2024-04-20",
        "certification_date": "2024-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tracy, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2024; 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.