Active NPI
Steven Ray Zollman, D.M.D.
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1679664114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 103434
- Practice address
- 48 E Santa Clara St
San Jose, CA 95113-1802 - Phone
- (877) 320-3195
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D4198 | ID | |
| General Practice Dentistry | 1223G0001X | D5597 | OR | |
| General Practice Dentistry | 1223G0001X | 103434 | CA | Primary |
Addresses
Primary practice location
48 E Santa Clara St
San Jose, CA 95113-1802
Mailing address
330 Crescent Village Cir Unit 2320
San Jose, CA 95134-3557
Phone (541) 398-0635
Other practice location 1
2825 El Camino Real
Santa Clara, CA 95051-2901
Phone (877) 320-3195
Other practice location 2
401 B North Main
Joseph, OR 97846
Phone (541) 432-6555
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 |
|---|---|---|---|
| 103434 | CA | MD | Marriage & Family Therapist |
| D4198 | ID | MD | General Practice Dentistry |
| D5597 | OR | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chief Joseph Dental Clinic, LLC | 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.
-
- Dental Clinic/Center
- Joseph, OR
- NPI 1285947721
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551052800000",
"number": "1679664114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 CRESCENT VILLAGE CIR UNIT 2320",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951343557",
"telephone_number": "541-398-0635",
"fax_number": "541-432-5051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48 E SANTA CLARA ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951131802",
"telephone_number": "877-320-3195"
}
],
"practiceLocations": [
{
"address_1": "2825 El Camino Real",
"address_purpose": "LOCATION",
"city": "Santa Clara",
"state": "CA",
"postal_code": "950512901",
"country_code": "US",
"telephone_number": "877-320-3195",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "401 B North Main",
"address_purpose": "LOCATION",
"city": "Joseph",
"state": "OR",
"postal_code": "97846",
"country_code": "US",
"telephone_number": "541-432-6555",
"fax_number": "541-432-5051",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ZOLLMAN",
"first_name": "STEVEN",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2019-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D4198",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OR",
"license": "D5597",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "103434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.