Individual provider Active NPI

Rebecca P Hsieh, DDS

  • Pediatric Dentistry
  • Mill Valley, CA
National Provider Identifier
1386202414
Registry record updated Mar 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
102094 Issued in CA
Practice address
163 Miller Ave Ste 2
Mill Valley, CA 94941-2759
Phone
(415) 751-7900
NPI assigned
Jun 4, 2019
Last updated
Mar 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2023

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 102094 CA Primary

Addresses

Primary practice location

163 Miller Ave Ste 2
Mill Valley, CA 94941-2759

Mailing address

3349 Washington CT
Alameda, CA 94501-5575
Phone (858) 216-5117

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
I20190703002145 CA Order and Referring Only - DentistPractitioner - Dentist 6305171893

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102094CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678060800000",
    "number": "1386202414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 WASHINGTON CT",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015575",
            "telephone_number": "858-216-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 MILLER AVE STE 2",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412759",
            "telephone_number": "415-751-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HSIEH",
        "first_name": "REBECCA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-04",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "102094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

Verify at the official NPI Registry.