Active NPI
Stanko Bjelajac, DDS
- Dentist
- Palo Alto, CA
National Provider Identifier
1932452638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- LL-307-12
- Practice address
- 1795 El Camino Real Ste 100
Palo Alto, CA 94306-1165 - Phone
- (310) 753-9966
- NPI assigned
- Oct 18, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | LL-307-12 | NV | Primary |
Addresses
Primary practice location
1795 El Camino Real Ste 100
Palo Alto, CA 94306-1165
Mailing address
9225 W Charleston Blvd Apt 1007
Las Vegas, NV 89117-7050
Phone (310) 753-9966
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 |
|---|---|---|---|
| LL-307-12 | NV | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627948800000",
"number": "1932452638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9225 W CHARLESTON BLVD APT 1007",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891177050",
"telephone_number": "310-753-9966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1795 EL CAMINO REAL STE 100",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943061165",
"telephone_number": "310-753-9966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BJELAJAC",
"first_name": "STANKO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-10-18",
"last_updated": "2021-08-03",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NV",
"license": "LL-307-12",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palo Alto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.