Active NPI
Elena Isabella Davidson, D.D.S.
- Dentist
- San Leandro, CA
National Provider Identifier
1497914501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56975
- Practice address
- 443 Joaquin Ave
Suite a
San Leandro, CA 94577-4902 - Phone
- (510) 352-9212
- Fax
- (510) 352-4313
- NPI assigned
- Jun 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 56975 | CA | Primary |
Addresses
Primary practice location
443 Joaquin Ave
Suite a
San Leandro, CA 94577-4902
Mailing address
443 Joaquin Ave
Suite a
San Leandro, CA 94577-4902
Phone (510) 352-9212
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
| License | State | Type | Specialty |
|---|---|---|---|
| 56975 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212451200000",
"number": "1497914501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "443 JOAQUIN AVE",
"address_2": "SUITE A",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774902",
"telephone_number": "510-352-9212",
"fax_number": "510-352-4313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "443 JOAQUIN AVE",
"address_2": "SUITE A",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774902",
"telephone_number": "510-352-9212",
"fax_number": "510-352-4313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "ELENA",
"middle_name": "ISABELLA",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-03",
"last_updated": "2008-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56975",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.