Alyssa Gianella Coulter

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109406 Issued in CA

Practice address

1528 S El Camino Real Ste 408
San Mateo, CA 94402-3067

Phone

(650) 212-3500

Fax

(650) 212-3505

NPI assigned

Apr 10, 2022

Last updated

Nov 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Samir Nanjapa DDS, a Dental Corporation

  dba Deccan Dental

  • Dentist
  • San Mateo, CA
  • NPI 1730525650
  NPD

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

{
    "created_epoch": "1649548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1750023743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "352 PINE ST",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940302019",
            "telephone_number": "650-274-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1528 S EL CAMINO REAL STE 408",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023067",
            "telephone_number": "650-212-3500",
            "fax_number": "650-212-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COULTER",
        "first_name": "ALYSSA",
        "middle_name": "GIANELLA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-10",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Costa
• Stephen Costakis
• Christian Cotton
• Jeanie Elizabeth Cotton, LMFT, MS
• Shawn Michael Cotton
• Counseling for Change: a Psychological Corporation (Counseling for Change)
• County of San Mateo (San Mateo Medical Center)
• County of San Mateo (San Mateo Medical Center)
• County of San Mateo (San Mateo Medical Center)
• County of San Mateo (San Mateo Medical Center)

• General Practice Dentistry in San Mateo, CA
• Providers in San Mateo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.