Individual provider Active NPI

Mamak Saffarpour, D.D.S

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1740218312
Registry record updated Oct 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49657 Issued in CA
Practice address
3535 Ross Ave Ste 200
San Jose, CA 95124-3038
Phone
(408) 269-2944
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2015

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 49657 CA Primary

Addresses

Primary practice location

3535 Ross Ave Ste 200
San Jose, CA 95124-3038

Mailing address

3535 Ross Ave Ste 200
San Jose, CA 95124-3038
Phone (408) 269-2944

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective May 2, 2017 through May 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
49657CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444953600000",
    "number": "1740218312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3535 ROSS AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243038",
            "telephone_number": "408-269-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 ROSS AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951243038",
            "telephone_number": "408-269-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFFARPOUR",
        "first_name": "MAMAK",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.