Active NPI
Yahya Radwan, DDS
- Pediatric Dentistry
- Sunnyvale, CA
National Provider Identifier
1417075649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 56047
- Practice address
- 1298 Kifer Rd
Suite 506
Sunnyvale, CA 94086-5320 - Phone
- (408) 736-3500
- NPI assigned
- Mar 26, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 050257 | NY | |
| Pediatric Dentistry | 1223P0221X | 56047 | CA | Primary |
Addresses
Primary practice location
1298 Kifer Rd
Suite 506
Sunnyvale, CA 94086-5320
Mailing address
1298 Kifer Rd
Suite 506
Sunnyvale, CA 94086-5320
Phone (408) 736-3500
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 |
|---|---|---|---|
| 050257 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210118400000",
"number": "1417075649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1298 KIFER RD",
"address_2": "SUITE 506",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940865320",
"telephone_number": "408-736-3500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1298 KIFER RD",
"address_2": "SUITE 506",
"city": "SUNNYVALE",
"state": "CA",
"postal_code": "940865320",
"telephone_number": "408-736-3500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADWAN",
"first_name": "YAHYA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2008-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "050257",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "56047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.