Active NPI
Amir Dadgar-Yeganeh, DDS
- Orthodontics and Dentofacial Orthopedics Dentistry
- San Jose, CA
National Provider Identifier
1609285691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 62830
- Practice address
- 3030 Alum Rock Ave
San Jose, CA 95127-2807 - Phone
- (310) 774-1372
- NPI assigned
- Aug 5, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 62830 | CA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 62830 | CA | Primary |
Addresses
Primary practice location
3030 Alum Rock Ave
San Jose, CA 95127-2807
Mailing address
1026 Noriega St
San Francisco, CA 94122-4514
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | amir.dadgaryegenah.p1@direct.eisnerhealth.nextgenshare.com | Health Information Exchange (HIE) |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170523002449 | CA | Order and Referring Only - Dentist | 8921375957 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 62830 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1609285691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1026 NORIEGA ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941224514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3030 ALUM ROCK AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951272807",
"telephone_number": "310-774-1372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DADGAR-YEGANEH",
"first_name": "AMIR",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-05",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "62830",
"primary": false
},
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "62830",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amir.dadgaryegenah.p1@direct.eisnerhealth.nextgenshare.com",
"affiliation": "N",
"endpointDescription": "NextGenShare, Carequality",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1530 S Olive St",
"city": "Los Angeles",
"state": "CA",
"country_code": "US",
"postal_code": "900153023",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.