AGE DEFY DERMATOLOGY AND WELLNESS INCORPORATED
NPI 1710172994
Dermatology - Procedural Dermatology in Campbell, CA

NPI Status: Active since September 11, 2007

Contact Information

3803 S BASCOM AVE
SUITE 200
CAMPBELL, CA
ZIP 95008
Phone: (408) 559-0988
Fax: (408) 369-4263

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  • Organization
  • Dermatology
  • Procedural Dermatology

About AGE DEFY DERMATOLOGY AND WELLNESS INCORPORATED

This page provides the complete NPI Profile along with additional information for Age Defy Dermatology And Wellness Incorporated, a provider established in Campbell, California operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1710172994 assigned on September 2007. The practitioner's primary taxonomy code is 207NS0135X with license number G422290 (CA). The provider is registered as an organization and their NPI record was last updated 19 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Age Defy Dermatology And Wellness Incorporated. The authorized official of this NPI record is Dr. Frank Richard Noodleman Md (Medical Director)

NPI
1710172994
Provider Legal Name
F. RICHARD NOODLEMAN MD A PROFESSIONAL CORPORATION
Other Organization Name
AGE DEFY DERMATOLOGY AND WELLNESS INCORPORATED
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3803 S BASCOM AVE SUITE 200 CAMPBELL, CA 95008
Location Phone
(408) 559-0988
Location Fax
(408) 369-4263
Mailing Address
3803 S BASCOM AVE SUITE 200 CAMPBELL, CA 95008
Mailing Phone
(408) 559-0988
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-11-2007
Last Update Date
10-24-2007
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology Procedural Dermatology

Taxonomy Code
207NS0135X
Type
Allopathic & Osteopathic Physicians
License No.
G422290
License State
CA
Taxonomy Description
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. FRANK RICHARD NOODLEMAN MD

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(408) 559-0988

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
A48868MEDICARE UPIN (02)CA 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1710172994, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
1
Doubled → 2
Pos 4
0
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
2
Doubled → 4
Pos 8
9
Unchanged
Pos 9
9
Doubled → 18 → 1 + 8
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 2 → 4 9 → 18 → 9

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 2 + 0 + 2 + 7 + 4 + 9 + 1 + 8 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1710172994.

Other Providers at the Same Location


The following 19 providers are registered at the same or a nearby location.

Thoracic Surgery (Cardiothoracic Vascular Surgery)
3803 S BASCOM AVE, STE 102
CAMPBELL, CA 95008
Plastic Surgery
3803 S BASCOM AVE, STE 100
CAMPBELL, CA 95008
Anesthesiology (Pain Medicine)
3803 S BASCOM AVE, SUITE 210
CAMPBELL, CA 95008
Physician Assistant
3803 S BASCOM AVE, SUITE 200
CAMPBELL, CA 95008
Surgery (Plastic and Reconstructive Surgery)
3803 S BASCOM AVE, SUITE 204
CAMPBELL, CA 95008
Specialist
3803 S BASCOM AVE, SUITE 210
CAMPBELL, CA 95008
Specialist
3803 S BASCOM AVE, SUITE 100
CAMPBELL, CA 95008
Clinic/Center (Ambulatory Surgical)
3803 S BASCOM AVE, SUITE 100
CAMPBELL, CA 95008
Thoracic Surgery (Cardiothoracic Vascular Surgery)
3803 S BASCOM AVE, SUITE 102B
CAMPBELL, CA 95008
Plastic Surgery
3803 S BASCOM AVE, SUITE 100
CAMPBELL, CA 95008
Physician Assistant (Surgical)
3803 S BASCOM AVE, SUITE 102
CAMPBELL, CA 95008
Surgery (Plastic and Reconstructive Surgery)
3803 S BASCOM AVE, SUITE 100
CAMPBELL, CA 95008
Specialist
3803 S BASCOM AVE, STE 104
CAMPBELL, CA 95008
Plastic Surgery
3803 S BASCOM AVE, STE 100
CAMPBELL, CA 95008
Dermatology (Procedural Dermatology)
3803 S BASCOM AVE, SUITE 200
CAMPBELL, CA 95008
Clinic/Center (Ambulatory Surgical)
3803 S BASCOM AVE
CAMPBELL, CA 95008
Surgery (Plastic and Reconstructive Surgery)
3803 S BASCOM AVE, SUITE 100
CAMPBELL, CA 95008
Clinic/Center (Ambulatory Surgical)
3803 S BASCOM AVE, SUITE 101
CAMPBELL, CA 95008
Nurse Practitioner (Family)
3803 S BASCOM AVE
CAMPBELL, CA 95008

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710172994, enumerated as an "organization" on September 11, 2007.

The provider is located at 3803 S BASCOM AVE SUITE 200 CAMPBELL, CA 95008 and the phone number is (408) 559-0988.

Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.