Individual provider Active NPI

Jayapriya Samaraj, D.D.S

  • General Practice Dentistry
  • Concord, CA
National Provider Identifier
1609013366
Registry record updated Jan 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
57327 Issued in CA
Practice address
3640 Clayton Rd
Apt 102
Concord, CA 94521-5188
Phone
(925) 429-0482
NPI assigned
Jan 16, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2009

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 57327 CA Primary

Addresses

Primary practice location

3640 Clayton Rd
Apt 102
Concord, CA 94521-5188

Mailing address

3640 Clayton Rd
Apt 102
Concord, CA 94521-5188
Phone (925) 429-0482

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

LicenseStateTypeSpecialty
57327CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1232064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232064000000",
    "number": "1609013366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 CLAYTON RD",
            "address_2": "APT 102",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945215188",
            "telephone_number": "925-429-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 CLAYTON RD",
            "address_2": "APT 102",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945215188",
            "telephone_number": "925-429-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMARAJ",
        "first_name": "JAYAPRIYA",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-16",
        "last_updated": "2009-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "57327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2009; 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.