Individual provider Active NPI

James Pennington

  • Dentist
  • Santa Clara, CA
National Provider Identifier
1740015080
Registry record updated Aug 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
112946 Issued in CA
Practice address
2712 Homestead Rd
Santa Clara, CA 95051-5353
Phone
(661) 310-1186
NPI assigned
Sep 5, 2024
Last updated
Aug 17, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 112946 CA Primary

Addresses

Primary practice location

2712 Homestead Rd
Santa Clara, CA 95051-5353

Mailing address

438 Oak Grove Dr Apt 503
Santa Clara, CA 95054-4330
Phone (720) 519-3849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20250916000009 NV Order and Referring Only - DentistPractitioner - Dentist 2365946290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8106NVMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Callaway-Nelson Lemmon Valley Dental Group PC PastSince Sep 8, 2024 Accepting new patients
Ahmad Mokbil and Dhaval Patel Dental Corporation PastSince Oct 20, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1725494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786924800000",
    "number": "1740015080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 OAK GROVE DR APT 503",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950544330",
            "telephone_number": "720-519-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 HOMESTEAD RD",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950515353",
            "telephone_number": "661-310-1186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-05",
        "last_updated": "2026-08-17",
        "certification_date": "2026-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "112946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.