Active NPI
Paul Robert Rhodes, DDS, MSD
- Periodontics
- Oakland, CA
National Provider Identifier
1407086242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 16821
- Practice address
- 6130 Skyline Blvd
Oakland, CA 94611-1062 - Phone
- (510) 595-4101
- Fax
- (510) 903-9241
- NPI assigned
- Jul 14, 2009
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 16821 | CA | Primary |
Addresses
Primary practice location
6130 Skyline Blvd
Oakland, CA 94611-1062
Mailing address
6130 Skyline Blvd
Oakland, CA 94611-1062
Phone (510) 595-4101
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 |
|---|---|---|---|
| 16821 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1407086242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6130 SKYLINE BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111062",
"telephone_number": "510-595-4101",
"fax_number": "510-903-9241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6130 SKYLINE BLVD",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946111062",
"telephone_number": "510-595-4101",
"fax_number": "510-903-9241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RHODES",
"first_name": "PAUL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-14",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "16821",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.