Individual provider Active NPI

Tina Siambis, DDS

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1467636290
Registry record updated Dec 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
28623 Issued in CA
Practice address
259 Meridian Ave
Ste 2
San Jose, CA 95126-2905
Phone
(408) 275-9477
Fax
(408) 275-9478
NPI assigned
Dec 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 28623 CA Primary

Addresses

Primary practice location

259 Meridian Ave
Ste 2
San Jose, CA 95126-2905

Mailing address

259 Meridian Ave
Ste 2
San Jose, CA 95126-2905
Phone (408) 275-9477

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

LicenseStateTypeSpecialty
28623CAMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1467636290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 MERIDIAN AVE",
            "address_2": "STE 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262905",
            "telephone_number": "408-275-9477",
            "fax_number": "408-275-9478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 MERIDIAN AVE",
            "address_2": "STE 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262905",
            "telephone_number": "408-275-9477",
            "fax_number": "408-275-9478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAMBIS",
        "first_name": "TINA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "28623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.