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DR. PEDRAM EISAPOORAN DDS
NPI 1104302652
Dentist in San Jose, CA

Active since July 18, 2018PECOS Enrolled
55 E JULIAN ST, SAN JOSE, CA 95112(408) 457-7100 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 1, 2025, Aug 16, 2024, Jul 28, 2024 and 22 more (25 updates tracked since 2018).

About Dr. Pedram Eisapooran Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. PEDRAM EISAPOORAN DDS (NPI 1104302652) is an individual dentist in San Jose, California, licensed in California (106013) and active in the NPI registry since July 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104302652
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. PEDRAM EISAPOORANCredential: DDS
Location Address55 E JULIAN STSan Jose, CA 95112-4007
Mailing Address55 E Julian StSan Jose, CA 95112-4007
Phone(408) 457-7100
Sole ProprietorNo
Enumeration DateJuly 18, 2018
Last NPPES UpdateApril 1, 202525 updates tracked since enumeration
NPPES CertifiedApril 1, 2025
✔ NPI 1104302652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
Licenses✔ Licensed in CA · 106013✔ Licensed in DC · DEN1001922✔ Licensed in TX · 36158
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
55 E JULIAN ST, San Jose, CA 95112
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Pedram Eisapooran Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95112 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$106.47 typical visit price
range $70.37 – $206.04
Typical copayment $26.61 (range $17.59 – $51.51)
Most-billed visit code 99203
Established Patient
$86.56 typical visit price
range $23.96 – $169.60
Typical copayment $21.64 (range $5.99 – $42.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. CECILIA K IMAMURA O.D.
Optometrist
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 918-2618
JEANETTE FEDASZ FNP
Nurse Practitioner
55 E JULIAN ST, MEDICAL ADMINISTRATION
SAN JOSE, CA 95112
Santa Clara County (408) 918-2600
SHUZING TSUNG
Nurse Practitioner (Family)
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 839-3423
VICTORIA LAI
Dentist
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 457-7100
HSIN-PEI LIU MD
Obstetrics & Gynecology
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 918-2600
MICHELLE MARIE TOSCANO
Physician Assistant (Medical)
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 918-2600
NAYYAR KHAN M.D.
Pediatrics
55 E JULIAN ST
SAN JOSE, CA 95112
Santa Clara County (408) 918-2600
DR. MONIKA DAHIYA D.M.D.
Dentist
55 E JULIAN ST, ST. JAMES CLINIC
SAN JOSE, CA 95112
Santa Clara County (408) 918-2667

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pedram Eisapooran's NPI number?

The NPI number for Pedram Eisapooran is 1104302652. It was assigned to this individual provider in the NPPES registry on July 18, 2018.

Where is Pedram Eisapooran located?

Pedram Eisapooran practices at 55 E Julian St, San Jose, CA 95112. The listed phone number is (408) 457-7100.

What is Pedram Eisapooran's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Pedram Eisapooran enrolled in Medicare?

Yes. Pedram Eisapooran is registered in the Medicare PECOS enrollment system.

What insurance does Pedram Eisapooran accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and BEST Life and 9 other insurers list Pedram Eisapooran as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Pedram Eisapooran was last updated on April 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.