Individual provider Active NPI

Amber Nierode, D.D.S.

  • Pediatric Dentistry
  • Santa Rosa, CA
National Provider Identifier
1831577808
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DDS101176 Issued in CA
Practice address
515 Farmers LN
Santa Rosa, CA 95405-4917
Phone
(707) 527-8509
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DDS101176 CA Primary

Addresses

Primary practice location

515 Farmers LN
Santa Rosa, CA 95405-4917

Mailing address

515 Farmers LN
Santa Rosa, CA 95405-4917
Phone (714) 717-0364

Other practice location 1

7525 N Cedar Ave Ste 105
Fresno, CA 93720-2698
Phone (559) 439-6600

Other practice location 2

321 1st St Ste 203
Benicia, CA 94510-3268
Phone (707) 748-0500

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
DDS101176CAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Amber M. Nierode, DDS, Inc. Pediatric Dentistry CurrentSince Jun 1, 2020 Accepting new patients
Willett and Ramos Dental, PC Pediatric Dentistry PastSince Oct 20, 2019 Accepting new patients

Locations

321 1st St
Ste 203
Benicia, CA 94510
Phone (707) 745-8264

7525 N Cedar Ave
Ste 105
Fresno, CA 93720
Phone (559) 439-6600

515 Farmers Ln
Santa Rosa, CA 95405
Phone (707) 527-8509

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1831577808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054917",
            "telephone_number": "714-717-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FARMERS LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054917",
            "telephone_number": "707-527-8509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7525 N Cedar Ave Ste 105",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937202698",
            "country_code": "US",
            "telephone_number": "559-439-6600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "321 1st St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Benicia",
            "state": "CA",
            "postal_code": "945103268",
            "country_code": "US",
            "telephone_number": "707-748-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIERODE",
        "first_name": "AMBER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "DDS101176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; 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.