Individual provider Active NPI

Bridget Edwar Faltas, DDS

  • Periodontics
  • Sacramento, CA
National Provider Identifier
1396477758
Registry record updated Jun 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
111205 Issued in CA
Practice address
1102 Corporate Way # 150
Sacramento, CA 95831-3895
Phone
(562) 746-8706
NPI assigned
Jun 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 111205 CA Primary
Dentist 122300000X 10822 KY

Addresses

Primary practice location

1102 Corporate Way # 150
Sacramento, CA 95831-3895

Mailing address

1102 Corporate Way # 150
Sacramento, CA 95831-3895
Phone (562) 746-8706

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
10822KYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1656115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750636800000",
    "number": "1396477758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 CORPORATE WAY # 150",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313895",
            "telephone_number": "562-746-8706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 CORPORATE WAY # 150",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958313895",
            "telephone_number": "562-746-8706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALTAS",
        "first_name": "BRIDGET",
        "middle_name": "EDWAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-25",
        "last_updated": "2025-06-23",
        "certification_date": "2025-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "111205",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "10822",
            "primary": false
        }
    ],
    "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 Jun 23, 2025; 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.