Shyama Subhadarsini, D.D.S., B.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63873 Issued in CA

Practice address

4155 Moorpark Ave Ste 17
San Jose, CA 95117-1714

Phone

(408) 249-7762

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Shyama Subhadarsini DDS Inc

  • Dental Clinic/Center
  • San Jose, CA
  • NPI 1912647629
  NPD Authorized official
• David L. Joyce DDS a Dental Corp

  • Dentist
  • San Jose, CA
  • NPI 1972617348
  NPD (past)

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1407256464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 17",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "408-249-7762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4155 MOORPARK AVE STE 17",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951171714",
            "telephone_number": "408-249-7762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "166 W Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Campbell",
            "state": "CA",
            "postal_code": "95008",
            "country_code": "US",
            "telephone_number": "408-379-0851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5150 Graves Ave",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951295013",
            "country_code": "US",
            "telephone_number": "408-973-0979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUBHADARSINI",
        "first_name": "SHYAMA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., B.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2022-03-30",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63873",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Dumagay Suaviso
• Lucas Suazo Gladwin, MD
• Jennifer G. Suba, RN
• Edward Louis Subega, LMFT
• Elisabeth Subega
• Linda Christine Subia-Stovich
• Krystal Lani Subia, B.A.
• Nadia Sublaban
• Caitlin Sublet
• Anuradha Subramanian, LCSW, CCM

• General Practice Dentistry in San Jose, CA
• Providers in San Jose, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.