Active NPI
William Bennett Iliff, DDS
- General Practice Dentistry
- Sacramento, CA
National Provider Identifier
1386775567
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 32925
- Practice address
- 5340 Elvas Ave
Suite 400
Sacramento, CA 95819-2345 - Phone
- (916) 451-2002
- Fax
- (916) 451-7641
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 32925 | CA | Primary |
Addresses
Primary practice location
5340 Elvas Ave
Suite 400
Sacramento, CA 95819-2345
Mailing address
5340 Elvas Avenue
Suite 400
Sacramento, CA 95819
Phone (916) 451-2002
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
| License | State | Type | Specialty |
|---|---|---|---|
| 32925 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1386775567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5340 ELVAS AVENUE",
"address_2": "SUITE 400",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95819",
"telephone_number": "916-451-2002",
"fax_number": "916-451-7641"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5340 ELVAS AVE",
"address_2": "SUITE 400",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958192345",
"telephone_number": "916-451-2002",
"fax_number": "916-451-7641"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILIFF",
"first_name": "WILLIAM",
"middle_name": "BENNETT",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "32925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.