Individual provider Active NPI

Anchita Venkatesh, DMD

  • General Practice Dentistry
  • Oakland, CA
National Provider Identifier
1861978454
Registry record updated Apr 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103629 Issued in CA
Practice address
1411 E 31St St
Oakland, CA 94602-1092
Phone
(510) 437-4473
NPI assigned
Jul 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 103629 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1411 E 31St St
Oakland, CA 94602-1092

Mailing address

3680 Beacon Ave Apt 320
Fremont, CA 94538-3046

Other practice location 1

20 York St
New Haven, CT 06510-3220
Phone (203) 688-2464

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
I20200601001167 CA Practitioner - Dentist 7810247665 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103629CAMDClinical Social Worker
12329CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Alameda Health System Current Accepting new patients
Alameda Health System CurrentSince Apr 27, 2020 Accepting new patients
Alameda Health System CurrentSince Apr 27, 2020 Accepting new patients
Alameda Health System Past Accepting new patients

Locations

815 Atlantic Ave
Ste 100
Alameda, CA 94501
Phone (510) 522-6637

2070 Clinton Ave
Alameda, CA 94501
Phone (510) 522-3700

15400 Foothill Blvd
Castro Valley, CA 94578
Phone (510) 346-1468

6955 Foothill Blvd
Ste 200
Oakland, CA 94605
Phone (510) 567-5700

1411 E 31st St
Oakland, CA 94602
Phone (510) 437-4323

7677 Oakport St
Ste 1200
Oakland, CA 94621
Phone (510) 618-5768

13855 E 14th St
San Leandro, CA 94578
Phone (510) 357-6500

Organizations & group practices 4

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": "1531785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585958400000",
    "number": "1861978454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 BEACON AVE APT 320",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945383046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 E 31ST ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946021092",
            "telephone_number": "510-437-4473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 York St",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065103220",
            "country_code": "US",
            "telephone_number": "203-688-2464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VENKATESH",
        "first_name": "ANCHITA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-17",
        "last_updated": "2020-04-04",
        "certification_date": "2020-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103629",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.