NPIMap

Organization Active NPI

Mohamad Iqball Rajabally

  • General Practice Dentistry
  • Newark, CA
National Provider Identifier
1487831921
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
36418 Issued in CA
Legal business name
MOHAMAD IQBALL RAJABALLY
Practice address
39675 Cedar Blvd
St 100
Newark, CA 94560
Phone
(510) 657-5510
Fax
(510) 657-5510
NPI assigned
Jan 28, 2008
Last updated
Oct 8, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

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

Authorized official

Name
Dr. Mohamad Iaball RajaballyNPI 1952328502
Title
Dentist Owner
Phone
(510) 657-5510

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
General Practice Dentistry 1223G0001X 36418 CA Primary

Addresses

Primary practice location

39675 Cedar Blvd
St 100
Newark, CA 94560

Mailing address

39675 Cedar Blvd
St 100
Newark, CA 94560
Phone (510) 657-5510

Other identifiers 1

IdentifierTypeStateIssuer
B36418-01OtherCAMEDI-CAL

National Provider Directory

National Provider Directory

Locations

39675 Cedar Blvd
Ste 100
Newark, CA 94560
Phone (510) 657-5510

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1201478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444262400000",
    "number": "1487831921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39675 CEDAR BLVD",
            "address_2": "ST 100",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "94560",
            "telephone_number": "510-657-5510",
            "fax_number": "510-657-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39675 CEDAR BLVD",
            "address_2": "ST 100",
            "city": "NEWARK",
            "state": "CA",
            "postal_code": "94560",
            "telephone_number": "510-657-5510",
            "fax_number": "510-657-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOHAMAD IQBALL RAJABALLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-28",
        "last_updated": "2015-10-08",
        "status": "A",
        "authorized_official_last_name": "RAJABALLY",
        "authorized_official_first_name": "MOHAMAD",
        "authorized_official_middle_name": "IABALL",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "510-657-5510",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "36418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL",
            "identifier": "B36418-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; 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.