Active NPI
Raman Emanuel Nazari, DDS
- Dentist
- San Jose, CA
National Provider Identifier
1871088971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DDS102627
- Practice address
- 1670 Hillsdale Ave Ste 20
San Jose, CA 95124-3241 - Phone
- (408) 377-3214
- Fax
- (408) 377-3288
- NPI assigned
- Jun 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DDS102627 | CA | Primary |
Addresses
Primary practice location
1670 Hillsdale Ave Ste 20
San Jose, CA 95124-3241
Mailing address
1574 Sunnyvale Ave Apt 35
Walnut Creek, CA 94597-1929
Phone (408) 599-8029
Other practice location 1
33141 Alvarado Niles Rd
Union City, CA 94587-3109
Phone (510) 431-5399
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS102627 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Davis Street Community Center Incorporated | Current | Accepting new patients | |
| Dipali Dave DDS Inc | Past | Accepting new patients |
Locations
3081 Teagarden St
San Leandro, CA 94577
Phone (510) 347-4620
Interoperability endpoints
- https://api.platform.athenahealth.com/9743/brand/1/csg/1/fhir/r4
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.
-
- Federally Qualified Health Center (FQHC)
- San Leandro, CA
- NPI 1215358924
-
- General Practice Dentistry
- Union City, CA
- NPI 1588878284
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1530316800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676505600000",
"number": "1871088971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1574 SUNNYVALE AVE APT 35",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945971929",
"telephone_number": "408-599-8029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 HILLSDALE AVE STE 20",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951243241",
"telephone_number": "408-377-3214",
"fax_number": "408-377-3288"
}
],
"practiceLocations": [
{
"address_1": "33141 Alvarado Niles Rd",
"address_purpose": "LOCATION",
"city": "Union City",
"state": "CA",
"postal_code": "945873109",
"country_code": "US",
"telephone_number": "510-431-5399",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NAZARI",
"first_name": "RAMAN",
"middle_name": "EMANUEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-30",
"last_updated": "2023-02-16",
"certification_date": "2023-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "DDS102627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.