Active NPI
Ann Khazzandra Miranda
- Dentist
- Livermore, CA
National Provider Identifier
1598840407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 50388
- Practice address
- 4432 Las Positas Rd
Livermore, CA 94551-9529 - Phone
- (925) 724-2422
- NPI assigned
- Oct 26, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 50388 | CA | Primary |
Addresses
Primary practice location
4432 Las Positas Rd
Livermore, CA 94551-9529
Mailing address
2656 Melbourne Way
San Ramon, CA 94582-5768
Phone (510) 673-6707
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 |
|---|---|---|---|
| 50388 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598840407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2656 MELBOURNE WAY",
"city": "SAN RAMON",
"state": "CA",
"postal_code": "945825768",
"telephone_number": "510-673-6707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4432 LAS POSITAS RD",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945519529",
"telephone_number": "925-724-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIRANDA",
"first_name": "ANN",
"middle_name": "KHAZZANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "50388",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.