Organization Active NPI

Amber M. Nierode, DDS, Inc.

  • Pediatric Dentistry
  • Santa Rosa, CA
National Provider Identifier
1477080901
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
AMBER M. NIERODE, DDS, INC.
Practice address
515 Farmers LN
Santa Rosa, CA 95405-4917
Phone
(714) 717-0364
NPI assigned
May 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Authorized official

Name
Dr. Amber Michelle Nierode, DDSNPI 1831577808
Title
Pediatric Dentist
Phone
(714) 717-0364

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
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

515 Farmers LN
Santa Rosa, CA 95405-4917

Mailing address

515 Farmers LN
Santa Rosa, CA 95405-4917
Phone (714) 717-0364

Other names 1

  • Santa Rosa Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

321 1st St
Ste 203
Benicia, CA 94510
Phone (707) 745-8264

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1477080901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054917",
            "telephone_number": "714-717-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054917",
            "telephone_number": "714-717-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBER M. NIERODE, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-15",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "NIERODE",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "714-717-0364",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Santa Rosa Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.