Active NPI
Susan Jane Gefvert
- General Practice Dentistry
- Concord, CA
National Provider Identifier
1811020191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D33089
- Practice address
- 2907 Salivo Street
Concord, CA 94519 - Phone
- (925) 689-4212
- NPI assigned
- Mar 14, 2007
- 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 | D33089 | CA | Primary |
Addresses
Primary practice location
2907 Salivo Street
Concord, CA 94519
Mailing address
2907 Salivo Street
Concord, CA 94519
Phone (925) 689-4212
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 509859 | Medicaid | CA |
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 |
|---|---|---|---|
| D33089 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811020191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2907 SALIVO STREET",
"city": "CONCORD",
"state": "CA",
"postal_code": "94519",
"telephone_number": "925-689-4212",
"fax_number": "925-689-5212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 SALIVO STREET",
"city": "CONCORD",
"state": "CA",
"postal_code": "94519",
"telephone_number": "925-689-4212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEFVERT",
"first_name": "SUSAN",
"middle_name": "JANE",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "D33089",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "509859",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.