Active NPI
Jared Gareth Danielson, DDS
- Pediatric Dentistry
- El Dorado Hills, CA
National Provider Identifier
1609903541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 52846
- Practice address
- 4517 Serrano Pkwy Ste 102
El Dorado Hills, CA 95762-7569 - Phone
- (916) 573-3387
- Fax
- (916) 919-8521
- NPI assigned
- Feb 27, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 52846 | CA | Primary |
Addresses
Primary practice location
4517 Serrano Pkwy Ste 102
El Dorado Hills, CA 95762-7569
Mailing address
4517 Serrano Pkwy Ste 102
El Dorado Hills, CA 95762-7569
Phone (916) 573-3387
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 |
|---|---|---|---|
| 52846 | CA | MD | Physical Medicine & Rehabilitation Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ryan Wittwer DDS & Joseph Rawlins DDS | Pediatric Dentistry | 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.
-
- Pediatric Dentistry
- Fair Oaks, CA
- NPI 1275887374
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649203200000",
"number": "1609903541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4517 SERRANO PKWY STE 102",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957627569",
"telephone_number": "916-573-3387",
"fax_number": "916-919-8521"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4517 SERRANO PKWY STE 102",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957627569",
"telephone_number": "916-573-3387",
"fax_number": "916-919-8521"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANIELSON",
"first_name": "JARED",
"middle_name": "GARETH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-27",
"last_updated": "2022-04-06",
"certification_date": "2022-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "52846",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.