Individual provider Active NPI

Rena Bains, D.D.S.

  • Periodontics
  • Modesto, CA
National Provider Identifier
1669487468
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
43683 Issued in CA
Practice address
2301 St. Pauls Way
Modesto, CA 95355-3390
Phone
(209) 578-4153
Fax
(209) 578-0725
NPI assigned
Jul 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 43683 CA Primary

Addresses

Primary practice location

2301 St. Pauls Way
Modesto, CA 95355-3390

Mailing address

2301 St. Pauls Way
Modesto, CA 95355-3390
Phone (209) 578-4153

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: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 30, 2013 through Apr 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
43683CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Rena Bains DDS Inc Periodontics 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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669487468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ST. PAULS WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553390",
            "telephone_number": "209-578-4153",
            "fax_number": "209-578-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ST. PAULS WAY",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953553390",
            "telephone_number": "209-578-4153",
            "fax_number": "209-578-0725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAINS",
        "first_name": "RENA",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "43683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Modesto, CA

Sources for this page

Verify at the official NPI Registry.