Individual provider Active NPI

David Mason Perry, DDS

  • Pediatric Dentistry
  • Alameda, CA
National Provider Identifier
1356486856
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22170 Issued in CA
Practice address
1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185
Phone
(510) 521-5437
Fax
(510) 865-1576
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22170 CA Primary

Addresses

Primary practice location

1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185

Mailing address

1105 Atlantic Ave Ste 101
Alameda, CA 94501-1185
Phone (510) 521-5016

Other practice location 1

2125 Whitehall Place
Alameda, CA 94501
Phone (510) 521-5016

Other identifiers 3

IdentifierTypeStateIssuer
D22170OtherCAHEALTHY FAMILIES
B22170OtherCADENTI CAL
040448OtherUNITED CONCORDIA

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

Practice roles

OrganizationSpecialtyStatusNew patients
David M. Perry, DDS, Sharine Thenard, DDS, and Mylinh Ngo, DMD, Inc. Pediatric Dentistry CurrentSince Jul 24, 2022 Accepting new patients

Locations

1105 Atlantic Ave
Ste 101
Alameda, CA 94501
Phone (510) 521-5016

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1356486856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 ATLANTIC AVE STE 101",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011185",
            "telephone_number": "510-521-5016",
            "fax_number": "510-865-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 ATLANTIC AVE STE 101",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945011185",
            "telephone_number": "510-521-5437",
            "fax_number": "510-865-1576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2125 Whitehall Place",
            "address_purpose": "LOCATION",
            "city": "Alameda",
            "state": "CA",
            "postal_code": "94501",
            "country_code": "US",
            "telephone_number": "510-521-5016",
            "fax_number": "510-522-8283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERRY",
        "first_name": "DAVID",
        "middle_name": "MASON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "22170",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILIES",
            "identifier": "D22170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI CAL",
            "identifier": "B22170",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "040448",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alameda, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.