Individual provider Active NPI

Jeannie Y. Irvine, D.D.S.

  • General Practice Dentistry
  • Sunnyvale, CA
National Provider Identifier
1861538357
Registry record updated Sep 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
45666 Issued in CA
Practice address
990 W Fremont Ave Ste U1
Sunnyvale, CA 94087-3065
Phone
(408) 732-6773
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2025

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 45666 CA Primary

Addresses

Primary practice location

990 W Fremont Ave Ste U1
Sunnyvale, CA 94087-3065

Mailing address

990 W Fremont Ave Ste U1
Sunnyvale, CA 94087-3065
Phone (408) 732-6773

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150908002712 CA Order and Referring Only - DentistPractitioner - Dentist 9436465374
O20251111000732 CA DME Supplier - Oral Surgery - Dentist 5092205773 Practice locations: Sunnyvale, CA

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757116800000",
    "number": "1861538357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE STE U1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873065",
            "telephone_number": "408-732-6773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W FREMONT AVE STE U1",
            "city": "SUNNYVALE",
            "state": "CA",
            "postal_code": "940873065",
            "telephone_number": "408-732-6773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRVINE",
        "first_name": "JEANNIE",
        "middle_name": "Y.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2025-09-06",
        "certification_date": "2025-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyvale, CA

Sources for this page

Verify at the official NPI Registry.