Individual provider Active NPI

Megha Raja Jadhav, DMD

  • General Practice Dentistry
  • Fairfield, CA
National Provider Identifier
1386706273
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57744 Issued in CA
Practice address
1900 Pennsylvania Ave
B2
Fairfield, CA 94533-3690
Phone
(707) 427-3111
Fax
(707) 427-3893
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 57744 CA Primary

Addresses

Primary practice location

1900 Pennsylvania Ave
B2
Fairfield, CA 94533-3690

Mailing address

1900 Pennsylvania Ave
B2
Fairfield, CA 94533-3690
Phone (707) 427-3111

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
I20161230000818 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6103107305

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
57744CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Megha Jadhav DMD, Inc Current Accepting new patients

Locations

1900 Pennsylvania Ave
Ste B2
Fairfield, CA 94533
Phone (707) 427-3111

Organizations & group practices 1

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1386706273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 PENNSYLVANIA AVE",
            "address_2": "B2",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333690",
            "telephone_number": "707-427-3111",
            "fax_number": "707-427-3893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 PENNSYLVANIA AVE",
            "address_2": "B2",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945333690",
            "telephone_number": "707-427-3111",
            "fax_number": "707-427-3893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JADHAV",
        "first_name": "MEGHA",
        "middle_name": "RAJA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.