Individual provider Active NPI

James Warren, D.D.S.

  • General Practice Dentistry
  • Millbrae, CA
National Provider Identifier
1861877623
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
64795 Issued in CA
Practice address
453 Broadway
Millbrae, CA 94030-1905
Phone
(650) 697-2073
NPI assigned
Jul 22, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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 64795 CA Primary

Addresses

Primary practice location

453 Broadway
Millbrae, CA 94030-1905

Mailing address

453 Broadway
Millbrae, CA 94030-1905
Phone (650) 697-2073

Other practice location 1

181 2nd Ave Ste 575
San Mateo, CA 94401-3838
Phone (650) 532-3092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160315000778 CA Order and Referring Only - DentistPractitioner - Dentist 6709182983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
64795CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Chris Johns DDS Inc PastSince Apr 25, 2021 Accepting new patients

Organizations & group practices 1

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": "1437523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1861877623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301905",
            "telephone_number": "650-697-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 BROADWAY",
            "city": "MILLBRAE",
            "state": "CA",
            "postal_code": "940301905",
            "telephone_number": "650-697-2073"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "181 2nd Ave Ste 575",
            "address_purpose": "LOCATION",
            "city": "San Mateo",
            "state": "CA",
            "postal_code": "944013838",
            "country_code": "US",
            "telephone_number": "650-532-3092",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WARREN",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millbrae, CA

Sources for this page

Verify at the official NPI Registry.