Eric L. Axelrode, D.D.S., a Professional Corporation

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

ERIC L. AXELRODE, D.D.S., A PROFESSIONAL CORPORATION

Practice address

1016 Country Club Dr
Moraga, CA 94556-1924

Phone

(925) 376-2800

Fax

(925) 376-7950

NPI assigned

Jul 11, 2024

Organization subpart

No

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

Authorized official

Name

Yasmine Karavattuveetil

Title

RCM Director

Phone

(916) 306-7576

Specialties & licenses 1

Addresses

Other names 1

• Axelrode Orthodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Louis Axelrode, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Moraga, CA
  • NPI 1710193750
  NPD (past)

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720656000000",
    "number": "1376380899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 BEACON BLVD",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956913462",
            "telephone_number": "916-306-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 COUNTRY CLUB DR",
            "city": "MORAGA",
            "state": "CA",
            "postal_code": "945561924",
            "telephone_number": "925-376-2800",
            "fax_number": "925-376-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC L. AXELRODE, D.D.S., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A",
        "authorized_official_last_name": "KARAVATTUVEETIL",
        "authorized_official_first_name": "YASMINE",
        "authorized_official_title_or_position": "RCM DIRECTOR",
        "authorized_official_telephone_number": "916-306-7576"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Axelrode Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elena Davydova, LLMSW
• Divine Health Inc
• Justine Dolan, MS, CCC-SLP
• Niva Dotan
• Sally Elton, ATC
• Karen A Ferguson, PHD
• Rhiannon Geving, MATRN, ATC
• Rachel Lee Goldberg-Lapointe
• Kelley Griest, M.S., CCC-SLP
• Alicia Michele Griffith, MPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Moraga, CA
• Providers in Moraga, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.