Individual provider Active NPI

Andrew A Dela Rama, D.D.S

  • General Practice Dentistry
  • South San Francisco, CA
National Provider Identifier
1568680858
Registry record updated Apr 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53780 Issued in CA
Practice address
3540 Callan Blvd Ste 201
South San Francisco, CA 94080-5100
Phone
(650) 878-0651
NPI assigned
Apr 23, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2020

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 53780 CA Primary

Addresses

Primary practice location

3540 Callan Blvd Ste 201
South San Francisco, CA 94080-5100

Mailing address

3540 Callan Blvd Ste 201
South San Francisco, CA 94080-5100
Phone (650) 878-0651

Other practice location 1

120 S El Camino Real Ste 19
Millbrae, CA 94030-3133
Phone (650) 239-9627

Other practice location 2

980 King Plz
Suite 1
Daly City, CA 94015-4450
Phone (650) 878-0651

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dela Rama a&M Dental Corporation CurrentSince Feb 21, 2021 Accepting new patients
Bonita Clemente Dela Rama, DDS Inc. General Practice Past Accepting new patients

Locations

120 S El Camino Real
Ste 19
Millbrae, CA 94030
Phone (650) 239-9627

3540 Callan Blvd
Ste 201
South San Francisco, CA 94080
Phone (650) 878-0651

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587081600000",
    "number": "1568680858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 CALLAN BLVD STE 201",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805100",
            "telephone_number": "650-878-0651",
            "fax_number": "650-878-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 CALLAN BLVD STE 201",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940805100",
            "telephone_number": "650-878-0651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 S El Camino Real Ste 19",
            "address_purpose": "LOCATION",
            "city": "Millbrae",
            "state": "CA",
            "postal_code": "940303133",
            "country_code": "US",
            "telephone_number": "650-239-9627",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "980 King Plz",
            "address_2": "Suite 1",
            "address_purpose": "LOCATION",
            "city": "Daly City",
            "state": "CA",
            "postal_code": "940154450",
            "country_code": "US",
            "telephone_number": "650-878-0651",
            "fax_number": "650-878-9575",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELA RAMA",
        "first_name": "ANDREW",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2020-04-17",
        "certification_date": "2020-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2020; 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.