Mahsa Sadat Jafari

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107712 Issued in CA

Practice address

1110 N Dutton Ave
Santa Rosa, CA 95401-4606

Phone

(707) 396-5151

NPI assigned

Aug 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mjafari627994@direct.ochin.org
• Direct secure messaging: mjafari813862@direct.ochin.org

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.

• Santa Rosa Community Health Centers

  dba Vista Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1578631172
  Medicare reassignment NPD
• Santa Rosa Community Health Centers

  dba Caritas Campus

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1467180430
  NPD
• Santa Rosa Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1780195255
  NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Anaheim, CA
  • NPI 1609925957
  NPD (past)
• Santa Rosa Community Healt Centers

  dba Santa Rosa Community Dental Center

  • Federally Qualified Health Center (FQHC)
  • Santa Rosa, CA
  • NPI 1023439759
  NPD (past)

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1962139766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1527 RANGE AVE APT 3",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014230",
            "telephone_number": "408-646-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N DUTTON AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014606",
            "telephone_number": "707-396-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAFARI",
        "first_name": "MAHSA SADAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald D. Jacobs
• Robert Louis Jacobs
• Mark Edwin Jacobson, MD
• Jafa Pharmaceuticals, Inc. (Creekside Pharmacy)
• Jafa Pharmaceuticals, Inc. (Creekside Pharmacy)
• Robert Torin Jaffe, M.D.
• Ida Jahed, MD
• Lucelene Jaimes Perez
• Fary Jalili
• Naseer Ibraheem Jameel

• General Practice Dentistry in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; 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.