Individual provider Active NPI

Pallavi Rajendra Gole, DDS

  • General Practice Dentistry
  • Walnut Creek, CA
National Provider Identifier
1376612556
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
46063 Issued in CA
Practice address
2021 Ygnacio Valley Rd Ste D2
Walnut Creek, CA 94598
Phone
(925) 935-0574
NPI assigned
Nov 6, 2006
Last updated
Sep 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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 46063 CA Primary

Addresses

Primary practice location

2021 Ygnacio Valley Rd Ste D2
Walnut Creek, CA 94598

Mailing address

2021 Ygnacio Valley Rd Ste D2
Walnut Creek, CA 94598-3390
Phone (925) 935-0547

Other practice location 1

1875 Olympic Blvd Ste 201
Walnut Creek, CA 94596-5026
Phone (925) 935-0547

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
46063CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1376612556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 YGNACIO VALLEY RD STE D2",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983390",
            "telephone_number": "925-935-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 YGNACIO VALLEY RD STE D2",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-935-0574"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1875 Olympic Blvd Ste 201",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945965026",
            "country_code": "US",
            "telephone_number": "925-935-0547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLE",
        "first_name": "PALLAVI",
        "middle_name": "RAJENDRA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "46063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.