Active NPI
Madhavi Nettem, DDS
- General Practice Dentistry
- Redwood City, CA
National Provider Identifier
1518028109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 51983
- Practice address
- 401 Warren St #101
Redwood City, CA 94063 - Phone
- (650) 366-1116
- Fax
- (650) 363-1116
- NPI assigned
- Dec 13, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 51983 | CA | Primary |
Addresses
Primary practice location
401 Warren St #101
Redwood City, CA 94063
Mailing address
401 Warren St
#101
Redwood City, CA 94063-1578
Phone (650) 366-1116
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 |
|---|---|---|---|
| 51983 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269302400000",
"number": "1518028109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 WARREN ST",
"address_2": "#101",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631578",
"telephone_number": "650-366-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 WARREN ST #101",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "94063",
"telephone_number": "650-366-1116",
"fax_number": "650-363-1116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETTEM",
"first_name": "MADHAVI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2010-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "51983",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.