Individual provider Active NPI

Dennis A Prat

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1669563219
Registry record updated Jul 8, 2007
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Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33833 Issued in CA
Practice address
4215 Piedmont Ave
Oakland, CA 94611-4738
Phone
(510) 658-0110
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 33833 CA Primary

Addresses

Primary practice location

4215 Piedmont Ave
Oakland, CA 94611-4738

Mailing address

4215 Piedmont Ave
Oakland, CA 94611-4738
Phone (510) 658-0110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20161212000294 CA Order and Referring Only - DentistPractitioner - Dentist 3577843432

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33833CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669563219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114738",
            "telephone_number": "510-658-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114738",
            "telephone_number": "510-658-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAT",
        "first_name": "DENNIS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.