Michael Sedaghatfar, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

55862 Issued in CA

Practice address

711 D St
Suite 107
San Rafael, CA 94901-3707

Phone

(415) 482-9901

Fax

(415) 482-9902

NPI assigned

Oct 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Michael Seda Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

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.

• Michael Seda DMD, Ms and Mary Rachel Brinker DMD

  • Periodontics
  • San Rafael, CA
  • NPI 1902072267
  NPD (past)

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

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743465600000",
    "number": "1457530164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 D ST",
            "address_2": "SUITE 107",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013707",
            "telephone_number": "415-482-9901",
            "fax_number": "415-482-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 D ST",
            "address_2": "SUITE 107",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949013707",
            "telephone_number": "415-482-9901",
            "fax_number": "415-482-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDAGHATFAR",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-30",
        "last_updated": "2025-04-01",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "55862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SEDA",
            "prefix": "DR.",
            "credential": "D.M.D., M.S.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Periodontics in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.