Individual provider Active NPI

Peter Yanni

  • Periodontics
  • San Francisco, CA
National Provider Identifier
1922594381
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
102635 Issued in CA
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

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
102635CAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Rafik Yanni DDS a Professional Corporation PastSince Jun 15, 2021 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.

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.

Verify at the official NPI Registry.