Individual provider Active NPI

Steven Ray Zollman, D.M.D.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1679664114
Registry record updated Feb 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103434 Issued in CA
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

Updated by the provider on Feb 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
103434CAMDMarriage & Family Therapist
D4198IDMDGeneral Practice Dentistry
D5597ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew 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.

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.

Verify at the official NPI Registry.