Individual provider Active NPI

Jennifer Soh, DDS

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1356515837
Registry record updated Aug 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61882 Issued in CA
Practice address
3050 E 16TH St
Oakland, CA 94601-2319
Phone
(510) 535-4700
Fax
(510) 535-4225
NPI assigned
Apr 16, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61882 CA Primary

Addresses

Primary practice location

3050 E 16TH St
Oakland, CA 94601-2319

Mailing address

PO Box 22210
Oakland, CA 94623-2210
Phone (510) 535-4000

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
I20151217001449 CA Order and Referring Only - DentistPractitioner - Dentist 4587703863

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
La Clinica de la Raza Inc Past Accepting new patients
La Clinica de la Raza Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jsoh294048@direct.ochin.org

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": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377648000000",
    "number": "1356515837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 22210",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946232210",
            "telephone_number": "510-535-4000",
            "fax_number": "510-535-4225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 E 16TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946012319",
            "telephone_number": "510-535-4700",
            "fax_number": "510-535-4225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOH",
        "first_name": "JENNIFER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-16",
        "last_updated": "2013-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.