Individual provider Active NPI

Varsha Ahuja, DMD

  • General Practice Dentistry
  • Rohnert Park, CA
National Provider Identifier
1639548803
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS104307 Issued in CA
Practice address
6315 Commerce Blvd
Rohnert Park, CA 94928
Phone
(707) 584-7401
NPI assigned
Sep 17, 2015
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DDS104307 CA Primary
General Practice Dentistry 1223G0001X DN1857073 MA

Addresses

Primary practice location

6315 Commerce Blvd
Rohnert Park, CA 94928

Mailing address

1117 Baywood Dr # 247
Petaluma, CA 94954-4318
Phone (978) 875-1785

Other practice location 1

1322 Worcester St
Natick, MA 01760-1501
Phone (508) 655-2900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151223001406 MA Order and Referring Only - DentistPractitioner - Dentist 1850692484

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS104307CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
42 North Dental Care, LLC Past Accepting new patients
Patel and Gill Dental Corporation PastSince Sep 29, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1639548803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 BAYWOOD DR # 247",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949544318",
            "telephone_number": "978-875-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6315 COMMERCE BLVD",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "94928",
            "telephone_number": "707-584-7401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1322 Worcester St",
            "address_purpose": "LOCATION",
            "city": "Natick",
            "state": "MA",
            "postal_code": "017601501",
            "country_code": "US",
            "telephone_number": "508-655-2900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AHUJA",
        "first_name": "VARSHA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS104307",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857073",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rohnert Park, CA

Sources for this page

Verify at the official NPI Registry.