Ichhya Pathak-Paudel, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1856425 Issued in MA

Practice address

1210, 106 East Park St
Ste 106
Hollister, CA 95023

Phone

(831) 902-2829

NPI assigned

Jun 11, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pathak-Paudel Dental PC

  • General Practice Dentistry
  • Hollister, CA
  • NPI 1366024432
  NPD Authorized official

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589500800000",
    "number": "1881032944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 JULIANN WAY",
            "city": "MORGAN HILL",
            "state": "CA",
            "postal_code": "950377549",
            "telephone_number": "203-512-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210, 106 EAST PARK ST",
            "address_2": "STE 106",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-902-2829"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "339 Squire Rd",
            "address_purpose": "LOCATION",
            "city": "Revere",
            "state": "MA",
            "postal_code": "021514309",
            "country_code": "US",
            "telephone_number": "781-286-7510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHAK-PAUDEL",
        "first_name": "ICHHYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristine Amber Padilla
• Gianni Paredez
• Isla Paredez
• Sung Jin Park, PA-C
• Pathak-Paudel Dental PC
• Danielle Patino
• Paul J Percival M D Medical Corporation
• Catherine Pavoni
• Beatriz Penilla
• Penny Wise Drug Co.

• General Practice Dentistry in Hollister, CA
• Providers in Hollister, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.

Verify at the official NPI Registry.