Individual provider Active NPI

Ahmad Alnatour, DDS

  • Endodontics
  • Manteca, CA
National Provider Identifier
1578795126
Registry record updated Dec 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D008528 Issued in AZ
Practice address
2288 Daniels St
Manteca, CA 95337-6706
Phone
(209) 456-5610
NPI assigned
Aug 17, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X D14119 MN
Endodontics 1223E0200X 61072 CA
Endodontics 1223E0200X D008528 AZ Primary

Addresses

Primary practice location

2288 Daniels St
Manteca, CA 95337-6706

Mailing address

2288 Daniels St
Manteca, CA 95337-6706
Phone (310) 570-8461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150901000315 CA Order and Referring Only - DentistPractitioner - Dentist 7315253754

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D008528AZMDEndodontist
61072CAMDEndodontist
D14119MNMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Robert P. Nakaki Dental Corporation PastSince Dec 26, 2021 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1250467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639958400000",
    "number": "1578795126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2288 DANIELS ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953376706",
            "telephone_number": "310-570-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2288 DANIELS ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953376706",
            "telephone_number": "209-456-5610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALNATOUR",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-17",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D14119",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "61072",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "AZ",
            "license": "D008528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.