Active NPI
Shaza Mardini, DDS, MS
- Oral and Maxillofacial Radiology Dentistry
- Sacramento, CA
National Provider Identifier
1780833087
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Radiology Dentistry
- License
- 48957
- Practice address
- 2745 Via Villaggio
Sacramento, CA 95864-3788 - Phone
- (916) 996-9969
- NPI assigned
- Sep 11, 2008
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Radiology Dentistry | 1223X0008X | 48957 | CA | Primary |
Addresses
Primary practice location
2745 Via Villaggio
Sacramento, CA 95864-3788
Mailing address
2745 Via Villaggio
Sacramento, CA 95864-3788
Phone (916) 996-9969
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48957 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1780833087",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2745 VIA VILLAGGIO",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958643788",
"telephone_number": "916-996-9969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2745 VIA VILLAGGIO",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958643788",
"telephone_number": "916-996-9969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARDINI",
"first_name": "SHAZA",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-09-11",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0008X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Radiology",
"state": "CA",
"license": "48957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.