Individual provider Active NPI

Danial Rezaei Kalantari

  • Dentist
  • El Dorado Hills, CA
National Provider Identifier
1649549130
Registry record updated Dec 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61075 Issued in CA
Practice address
3714 Aliso Dr
El Dorado Hills, CA 95762-7616
Phone
(916) 718-6655
NPI assigned
Dec 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61075 CA Primary

Addresses

Primary practice location

3714 Aliso Dr
El Dorado Hills, CA 95762-7616

Mailing address

3714 Aliso Dr
El Dorado Hills, CA 95762-7616
Phone (916) 718-6655

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61075CAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1649549130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 ALISO DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627616",
            "telephone_number": "916-718-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 ALISO DR",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957627616",
            "telephone_number": "916-718-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REZAEI KALANTARI",
        "first_name": "DANIAL",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-29",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

Verify at the official NPI Registry.