Active NPI
Mimi Salkola, DDS
- General Practice Dentistry
- Palo Alto, CA
National Provider Identifier
1790711372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 45612
- Practice address
- 3920 Middlefield Rd
Palo Alto, CA 94303-4733 - Phone
- (650) 813-6166
- Fax
- (650) 813-6166
- NPI assigned
- Jun 24, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 45612 | CA | Primary |
Addresses
Primary practice location
3920 Middlefield Rd
Palo Alto, CA 94303-4733
Mailing address
555 W Benjamin Holt Dr
Building B
Stockton, CA 95207-3839
Phone (209) 476-4700
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 |
|---|---|---|---|
| 45612 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242604800000",
"number": "1790711372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "555 W BENJAMIN HOLT DR",
"address_2": "BUILDING B",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952073839",
"telephone_number": "209-476-4700",
"fax_number": "209-478-6890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3920 MIDDLEFIELD RD",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943034733",
"telephone_number": "650-813-6166",
"fax_number": "650-813-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SALKOLA",
"first_name": "MIMI",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-24",
"last_updated": "2009-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "45612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.