Active NPI
Nidhi Jain, BDS, DMD, MS
- Periodontics
- Folsom, CA
National Provider Identifier
1457530651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 56089
- Practice address
- 2535 East Bidwell, Suite 150
Folsom, CA 95630 - Phone
- (916) 984-1109
- Fax
- (916) 984-1764
- NPI assigned
- Oct 24, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 56089 | CA | |
| Periodontics | 1223P0300X | 56089 | CA | Primary |
Addresses
Primary practice location
2535 East Bidwell, Suite 150
Folsom, CA 95630
Mailing address
9309 Office Park Circle, Suite 120
Elk Grove, CA 95758
Phone (916) 691-1050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 9, 2020 through Sep 9, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56089 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Capitol Periodontal Group | Periodontics | Past | Accepting new patients |
| Capitol Periodontal Group | Periodontics | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Periodontics
- Davis, CA
- NPI 1366908618
-
- Periodontics
- Folsom, CA
- NPI 1962735993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328659200000",
"number": "1457530651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9309 OFFICE PARK CIRCLE, SUITE 120",
"city": "ELK GROVE",
"state": "CA",
"postal_code": "95758",
"telephone_number": "916-691-1050",
"fax_number": "916-691-1066"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2535 EAST BIDWELL, SUITE 150",
"city": "FOLSOM",
"state": "CA",
"postal_code": "95630",
"telephone_number": "916-984-1109",
"fax_number": "916-984-1764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "NIDHI",
"credential": "BDS, DMD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-24",
"last_updated": "2012-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56089",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "56089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Folsom, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.