Mitali Samanta, B.D.S, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

52897 Issued in CA

Practice address

2660 5TH St
Ste C
Alameda, CA 94501

Phone

(510) 384-4000

NPI assigned

Dec 12, 2006

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

Other names 1

• Dr. Mitali Mukherjee Former name

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

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1912067422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ACACIA DR",
            "city": "ORINDA",
            "state": "CA",
            "postal_code": "945631703",
            "telephone_number": "415-378-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 5TH ST",
            "address_2": "STE C",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "94501",
            "telephone_number": "510-384-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMANTA",
        "first_name": "MITALI",
        "name_prefix": "Dr.",
        "credential": "B.D.S, D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52897",
            "primary": true
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CA",
            "license": "52897",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MITALI",
            "last_name": "MUKHERJEE",
            "prefix": "DR.",
            "credential": "B.D.S, D.D.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tyler Sakraida
• Martha Salas
• Maria Elena Salazar
• Miguelangel Cuahtemoc Salazar
• Alissa Saldivar, RNC, IBCLC
• David R Samlan, M.A, MFT
• Raquel Marisol Samphire
• Mary Samreuang
• San Jose Family Health Services Inc
• Laila Ngoc San

• Dentist in Alameda, CA
• Providers in Alameda, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.