Individual provider Active NPI

Tykeisha Denise Muhusin, D.D.S.

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1699052779
Registry record updated Sep 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
60914 Issued in CA
Practice address
5150 Graves Ave
Suite 11E
San Jose, CA 95129-5013
Phone
(408) 668-4144
NPI assigned
Nov 3, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2013

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 60914 CA Primary

Addresses

Primary practice location

5150 Graves Ave
Suite 11E
San Jose, CA 95129-5013

Mailing address

5150 Graves Ave
Suite 11E
San Jose, CA 95129-5013
Phone (408) 668-4144

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
60914CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377993600000",
    "number": "1699052779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE",
            "address_2": "SUITE 11E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295013",
            "telephone_number": "408-668-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE",
            "address_2": "SUITE 11E",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295013",
            "telephone_number": "408-668-4144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUHUSIN",
        "first_name": "TYKEISHA",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2013-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "60914",
            "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 Sep 1, 2013; 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.