Individual provider Active NPI

Bahareh Bakhtiari, DDS

  • Dentist
  • San Jose, CA
National Provider Identifier
1992104004
Registry record updated Jul 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63790 Issued in CA
Practice address
7028 Via Barranca
San Jose, CA 95139-1118
Phone
(408) 410-1029
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63790 CA Primary

Addresses

Primary practice location

7028 Via Barranca
San Jose, CA 95139-1118

Mailing address

7028 Via Barranca
San Jose, CA 95139-1118
Phone (408) 410-1029

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
63790CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469750400000",
    "number": "1992104004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7028 VIA BARRANCA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951391118",
            "telephone_number": "408-410-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7028 VIA BARRANCA",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951391118",
            "telephone_number": "408-410-1029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKHTIARI",
        "first_name": "BAHAREH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2016-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2016; 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.