NPIMap

Organization Active NPI

Dr. Jotsna's Dental Office

Doing business as Pearl Dental

  • General Practice Dentistry
  • Modesto, CA
National Provider Identifier
1407367824
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53790 Issued in CA
Legal business name
DR. JOTSNA'S DENTAL OFFICE
Doing business as
Pearl Dental
Practice address
3848 McHenry Ave Ste 130
Modesto, CA 95356-1599
Phone
(209) 523-2100
Fax
(209) 523-2101
NPI assigned
Oct 12, 2017
Last updated
Oct 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Authorized official

Name
Dr. Jotsna Gangadharan, DDSNPI 1467784835
Title
Owner/DDS
Phone
(209) 523-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53790 CA Primary

Addresses

Primary practice location

3848 McHenry Ave Ste 130
Modesto, CA 95356-1599

Mailing address

3848 McHenry Ave Ste 130
Modesto, CA 95356-1599
Phone (209) 523-2100

Other names 1

  • Pearl Dental Doing business as

National Provider Directory

National Provider Directory

Locations

3848 McHenry Ave
Ste 130
Modesto, CA 95356
Phone (209) 523-2100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507766400000",
    "number": "1407367824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3848 MCHENRY AVE STE 130",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953561599",
            "telephone_number": "209-523-2100",
            "fax_number": "209-523-2101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3848 MCHENRY AVE STE 130",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953561599",
            "telephone_number": "209-523-2100",
            "fax_number": "209-523-2101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOTSNA'S DENTAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A",
        "authorized_official_last_name": "GANGADHARAN",
        "authorized_official_first_name": "JOTSNA",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "209-523-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearl Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2017; 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.