Individual provider Active NPI

Betsabeh Doroudian Tehrani

  • General Practice Dentistry
  • Campbell, CA
National Provider Identifier
1811355035
Registry record updated Feb 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
65309 Issued in CA
Practice address
833 S San Tomas Aquino Rd.
Unit C
Campbell, CA 95008-4455
Phone
(408) 834-9159
NPI assigned
Feb 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2016

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 65309 CA Primary

Addresses

Primary practice location

833 S San Tomas Aquino Rd.
Unit C
Campbell, CA 95008-4455

Mailing address

833 S San Tomas Aquino Rd.
Unit C
Campbell, CA 95008-4455
Phone (408) 834-9159

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
65309CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454371200000",
    "number": "1811355035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 S SAN TOMAS AQUINO RD.",
            "address_2": "UNIT C",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950084455",
            "telephone_number": "408-834-9159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 S SAN TOMAS AQUINO RD.",
            "address_2": "UNIT C",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950084455",
            "telephone_number": "408-834-9159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOROUDIAN TEHRANI",
        "first_name": "BETSABEH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "65309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.