Active NPI
Preethi P. Joseph, D.D.S.
- Dentist
- San Mateo, CA
National Provider Identifier
1598073538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 59778
- Practice address
- 675 Mariner'S Island Blvd.
Suite 110
San Mateo, CA 94404 - Phone
- (650) 577-1988
- Fax
- (650) 577-0835
- NPI assigned
- Sep 23, 2010
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 59778 | CA | Primary |
Addresses
Primary practice location
675 Mariner'S Island Blvd.
Suite 110
San Mateo, CA 94404
Mailing address
675 Mariner'S Island Blvd.
Suite 110
San Mateo, CA 94404
Phone (650) 577-1988
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59778 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shirin Shahinfar Imani DDS Inc | Past | 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.
-
- General Practice Dentistry
- San Mateo, CA
- NPI 1154329084
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438560000000",
"number": "1598073538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "675 MARINER'S ISLAND BLVD.",
"address_2": "SUITE 110",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "94404",
"telephone_number": "650-577-1988",
"fax_number": "650-577-0835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "675 MARINER'S ISLAND BLVD.",
"address_2": "SUITE 110",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "94404",
"telephone_number": "650-577-1988",
"fax_number": "650-577-0835"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOSEPH",
"first_name": "PREETHI",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-23",
"last_updated": "2015-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "59778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.