Individual provider Active NPI

Rajesh Sunil Swamidass, DDS

  • General Practice Dentistry
  • Rancho Mirage, CA
National Provider Identifier
1356879316
Registry record updated Jun 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
63082 Issued in CA
Practice address
72027 Desert Dr
Rancho Mirage, CA 92270-4959
Phone
(760) 573-2232
NPI assigned
Jun 2, 2017
Last updated
Jun 2, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2017

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 63082 CA Primary

Addresses

Primary practice location

72027 Desert Dr
Rancho Mirage, CA 92270-4959

Mailing address

2595 Shady Glen LN
San Bernardino, CA 92408-4175
Phone (909) 747-5015

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
63082CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1496361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496361600000",
    "number": "1356879316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2595 SHADY GLEN LN",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924084175",
            "telephone_number": "909-747-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72027 DESERT DR",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922704959",
            "telephone_number": "760-573-2232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWAMIDASS",
        "first_name": "RAJESH",
        "middle_name": "SUNIL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-02",
        "last_updated": "2017-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Mirage, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2017; 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.