Active NPI
Shirin Hedayati, D.D.S
- General Practice Dentistry
- San Jose, CA
National Provider Identifier
1740673102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 36376
- Practice address
- 827 Blossom Hill Rd
Ste E8
San Jose, CA 95123-2701 - Phone
- (408) 578-4700
- NPI assigned
- Mar 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 36376 | CA | Primary |
Addresses
Primary practice location
827 Blossom Hill Rd
Ste E8
San Jose, CA 95123-2701
Mailing address
827 Blossom Hill Rd
Ste E8
San Jose, CA 95123-2701
Phone (408) 578-4700
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 |
|---|---|---|---|
| 36376 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hedayati Koo Adc | General Practice | 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.
-
- General Practice Dentistry
- San Jose, CA
- NPI 1215008925
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1425945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1425945600000",
"number": "1740673102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "827 BLOSSOM HILL RD",
"address_2": "STE E8",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951232701",
"telephone_number": "408-578-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "827 BLOSSOM HILL RD",
"address_2": "STE E8",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951232701",
"telephone_number": "408-578-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEDAYATI",
"first_name": "SHIRIN",
"name_prefix": "Dr.",
"credential": "D.D.S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-10",
"last_updated": "2015-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "36376",
"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 Mar 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.