Active NPI
Peter Yanni
- Periodontics
- San Francisco, CA
National Provider Identifier
1922594381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 102635
- Practice address
- 513 Parnassus Ave
San Francisco, CA 94143-2205 - Phone
- (415) 476-1323
- NPI assigned
- Jul 9, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 102635 | CA | |
| Periodontics | 1223P0300X | 102635 | CA | Primary |
Addresses
Primary practice location
513 Parnassus Ave
San Francisco, CA 94143-2205
Mailing address
2413 S Azusa Ave
West Covina, CA 91792-1536
Other practice location 1
2413 S Azusa Ave
West Covina, CA 91792-1536
Phone (626) 913-1421
Other practice location 2
1420 E Roseville Pkwy Ste 230
Roseville, CA 95661-3081
Phone (916) 788-1114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 102635 | CA | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rafik Yanni DDS a Professional Corporation | Past | Accepting new patients | |
| Nicky M Hakimi DDS Inc | Periodontics | Past | Accepting new patients |
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.
-
- Periodontics
- Roseville, CA
- NPI 1598810004
-
- Dental Clinic/Center
- West Covina, CA
- NPI 1760623912
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1922594381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2413 S AZUSA AVE",
"city": "WEST COVINA",
"state": "CA",
"postal_code": "917921536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 PARNASSUS AVE",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941432205",
"telephone_number": "415-476-1323"
}
],
"practiceLocations": [
{
"address_1": "2413 S Azusa Ave",
"address_purpose": "LOCATION",
"city": "West Covina",
"state": "CA",
"postal_code": "917921536",
"country_code": "US",
"telephone_number": "626-913-1421",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1420 E Roseville Pkwy Ste 230",
"address_purpose": "LOCATION",
"city": "Roseville",
"state": "CA",
"postal_code": "956613081",
"country_code": "US",
"telephone_number": "916-788-1114",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "YANNI",
"first_name": "PETER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-09",
"last_updated": "2021-06-10",
"certification_date": "2021-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CA",
"license": "102635",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "102635",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.