Individual provider Active NPI

Anjali Ayyappan, DDS

  • General Practice Dentistry
  • San Jose, CA
National Provider Identifier
1790446938
Registry record updated Jan 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
43313 Issued in CA
Practice address
1725 Berryessa Rd Ste B
San Jose, CA 95133-1173
Phone
(408) 259-2900
NPI assigned
Jan 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2022

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 43313 CA Primary

Addresses

Primary practice location

1725 Berryessa Rd Ste B
San Jose, CA 95133-1173

Mailing address

5259 Grosseto CT
San Jose, CA 95138-2602
Phone (408) 410-6085

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

LicenseStateTypeSpecialty
43313CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1641686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641686400000",
    "number": "1790446938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5259 GROSSETO CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382602",
            "telephone_number": "408-410-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 BERRYESSA RD STE B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951331173",
            "telephone_number": "408-259-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYYAPPAN",
        "first_name": "ANJALI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-09",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43313",
            "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 Jan 9, 2022; 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.