Individual provider Active NPI

Dean Funada, D.D.S.

  • Dentist
  • El Dorado Hills, CA
National Provider Identifier
1831418003
Registry record updated Nov 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
43960 Issued in CA
Practice address
897 Embarcadero Dr
Suite 211
El Dorado Hills, CA 95762-4097
Phone
(916) 933-5100
Fax
(916) 933-5187
NPI assigned
May 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 43960 CA Primary

Addresses

Primary practice location

897 Embarcadero Dr
Suite 211
El Dorado Hills, CA 95762-4097

Mailing address

897 Embarcadero Dr
Suite 211
El Dorado Hills, CA 95762-4097
Phone (916) 933-5100

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
43960CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637193600000",
    "number": "1831418003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "897 EMBARCADERO DR",
            "address_2": "SUITE 211",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957624097",
            "telephone_number": "916-933-5100",
            "fax_number": "916-933-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "897 EMBARCADERO DR",
            "address_2": "SUITE 211",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957624097",
            "telephone_number": "916-933-5100",
            "fax_number": "916-933-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNADA",
        "first_name": "DEAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-26",
        "last_updated": "2021-11-18",
        "certification_date": "2021-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2021; 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.