Individual provider Active NPI

Bardia Andre Sassani, DDS

  • General Practice Dentistry
  • Santa Clara, CA
National Provider Identifier
1962507467
Registry record updated Jul 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50525 Issued in CA
Practice address
261 Crestview Dr
Santa Clara, CA 95050-6503
Phone
(408) 247-8400
Fax
(408) 247-3918
NPI assigned
Sep 13, 2006
Last updated
Jul 17, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50525 CA Primary

Addresses

Primary practice location

261 Crestview Dr
Santa Clara, CA 95050-6503

Mailing address

261 Crestview Drive
Santa Clara, CA 95050
Phone (408) 247-8400

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150622001657 CA Order and Referring Only - DentistPractitioner - Dentist 0446561104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50525CAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bardia Andre Sassani DDS Inc General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1962507467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 CRESTVIEW DRIVE",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "95050",
            "telephone_number": "408-247-8400",
            "fax_number": "408-247-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 CRESTVIEW DR",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506503",
            "telephone_number": "408-247-8400",
            "fax_number": "408-247-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SASSANI",
        "first_name": "BARDIA",
        "middle_name": "ANDRE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Clara, CA

Sources for this page

Verify at the official NPI Registry.