Individual provider Active NPI

Elly Dimova Triplett, DDS

  • Dentist
  • Redwood City, CA
National Provider Identifier
1932249745
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
41318 Issued in CA
Practice address
114 Birch St
Suite a
Redwood City, CA 94062
Phone
(650) 368-7079
Fax
(650) 368-7079
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 41318 CA Primary

Addresses

Primary practice location

114 Birch St
Suite a
Redwood City, CA 94062

Mailing address

126 Flynn Ave
Apt B
Mountain View, CA 94043
Phone (650) 368-7079

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
41318CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932249745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 FLYNN AVE",
            "address_2": "APT B",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "94043",
            "telephone_number": "650-368-7079",
            "fax_number": "650-368-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 BIRCH ST",
            "address_2": "SUITE A",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "94062",
            "telephone_number": "650-368-7079",
            "fax_number": "650-368-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIPLETT",
        "first_name": "ELLY",
        "middle_name": "DIMOVA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "41318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.