Annie Chandy

Primary specialty

DentistTaxonomy code 122300000X

License

104343 Issued in CA

Practice address

4815 Watt Ave
North Highlands, CA 95660-5108

Phone

(916) 454-2345

NPI assigned

Aug 21, 2019

Last updated

Jun 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stout Dental Corporation

  dba Missouri Flat Dental Group

  • General Practice Dentistry
  • Placerville, CA
  • NPI 1396141750
  NPD (past)

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1881241164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 HOWE AVE STE 440",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958251098",
            "telephone_number": "916-569-8484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 WATT AVE",
            "city": "NORTH HIGHLANDS",
            "state": "CA",
            "postal_code": "956605108",
            "telephone_number": "916-454-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANDY",
        "first_name": "ANNIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "104343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Capital Dialysis Partnership (North Highlands Dialysis Center)
• Lynn Marie Carr, M.ED.
• Alexis Ricardo Carrillo
• Dennis Casido
• Theresa Irene Catalano, MFTI
• Kendra Chansler
• Child Abuse Prevention Council of Sacramento
• Daniel R Christensen
• Teresa L Cole, PPS
• Henry Alexander Collier

• Dentist in North Highlands, CA
• Providers in North Highlands, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.