Individual provider Active NPI

Derrick Low, D.M.D.

  • Dentist
  • Sunnyvale, CA
National Provider Identifier
1588049563
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
64736 Issued in CA
Practice address
662 E MC Kinley Ave
Sunnyvale, CA 94086-6450
Phone
(650) 387-5216
NPI assigned
Jul 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 64736 CA Primary

Addresses

Primary practice location

662 E MC Kinley Ave
Sunnyvale, CA 94086-6450

Mailing address

662 E MC Kinley Ave
Sunnyvale, CA 94086-6450
Phone (650) 387-5216

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
I20160329002261 CA Order and Referring Only - DentistPractitioner - Dentist 7618274044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64736CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1588049563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "662 E MC KINLEY AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866450",
            "telephone_number": "650-387-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "662 E MC KINLEY AVE",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940866450",
            "telephone_number": "650-387-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOW",
        "first_name": "DERRICK",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "64736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.