Active NPI
Nirmala Jyothi Marneni, DDS
- Dentist
- Modesto, CA
National Provider Identifier
1619131067
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57122
- Practice address
- 2605 Coffee Rd
#200
Modesto, CA 95355-2007 - Phone
- (209) 521-0100
- NPI assigned
- Jul 15, 2008
- 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 | 57122 | CA | Primary |
Addresses
Primary practice location
2605 Coffee Rd
#200
Modesto, CA 95355-2007
Mailing address
200 W Central Ave
Apt# 3616
Tracy, CA 95376-8190
Phone (408) 338-7299
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 |
|---|---|---|---|
| 57122 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, Inc. | Dentist | Past | Accepting new patients |
| Cherag Dinshaw Sarkari DDS a Dental Corporation | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Access Dental Centers
- General Practice Dentistry
- Modesto, CA
- NPI 1003970740
-
- Dentist
- Modesto, CA
- NPI 1306310933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216080000000",
"number": "1619131067",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W CENTRAL AVE",
"address_2": "APT# 3616",
"city": "TRACY",
"state": "CA",
"postal_code": "953768190",
"telephone_number": "408-338-7299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2605 COFFEE RD",
"address_2": "#200",
"city": "MODESTO",
"state": "CA",
"postal_code": "953552007",
"telephone_number": "209-521-0100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARNENI",
"first_name": "NIRMALA JYOTHI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-15",
"last_updated": "2008-07-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57122",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.