Rebecca Jardine, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50174 Issued in CA

Practice address

915 Village Ctr
Lafayette, CA 94549-3504

Phone

(510) 414-6840

Fax

(925) 356-2499

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Rebecca Jardine, DDS, Inc.

  • Dental Clinic/Center
  • Lafayette, CA
  • NPI 1083212591
  NPD Authorized official
• La Clinica de la Raza Inc

  • Federally Qualified Health Center (FQHC)
  • Oakland, CA
  • NPI 1346262292
  NPD (past)

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603324800000",
    "number": "1790888741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CALIFORNIA AVE",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945632105",
            "telephone_number": "510-414-6840",
            "fax_number": "510-535-4128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 VILLAGE CTR",
            "city": "LAFAYETTE",
            "state": "CA",
            "postal_code": "945493504",
            "telephone_number": "510-414-6840",
            "fax_number": "925-356-2499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARDINE",
        "first_name": "REBECCA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS50174",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marcia Sue Jacober, MFT
• Robert Jagger, MD
• Christopher Ross Jain
• Steven Jakobsen, D.C.
• James B Florey MD & Eugenia P Gary MD Inc
• Bianca Jarvis, LCSW
• Jenny Lam, DPM, Inc.
• Susan Marie Jenny, PH.D.
• Kirk L Jensen, MD
• Magda Jimenez Gallardo

• General Practice Dentistry in Lafayette, CA
• Providers in Lafayette, 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 Oct 22, 2020; 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.

Verify at the official NPI Registry.