Active NPI
Ruchika Agrawal, DMD
- Dentist
- Dublin, CA
National Provider Identifier
1790422970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS110185
- Practice address
- 3746 Fallon Rd
Dublin, CA 94568-7400 - Phone
- (617) 636-6828
- NPI assigned
- May 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1859483 | MA | |
| Dentist | 122300000X | DDS110185 | CA | Primary |
Addresses
Primary practice location
3746 Fallon Rd
Dublin, CA 94568-7400
Mailing address
253 Lucy CT
Fremont, CA 94539-3911
Phone (510) 894-9740
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230628003355 | MA | Order and Referring Only - Dentist | 6800255514 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS110185 | CA | MD | Dentist |
| DN1859483 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1790422970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "253 LUCY CT",
"city": "FREMONT",
"state": "CA",
"postal_code": "945393911",
"telephone_number": "510-894-9740"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3746 FALLON RD",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945687400",
"telephone_number": "617-636-6828"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGRAWAL",
"first_name": "RUCHIKA",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-18",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1859483",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS110185",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dublin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.