Isaiah Abdelmeseeh, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

109037 Issued in CA

Practice address

23905 Clinton Keith Rd
Wildomar, CA 92595-7897

Phone

(951) 741-3673

NPI assigned

Aug 7, 2023

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• La Puente Family Dentistry Apc

  • General Practice Dentistry
  • La Puente, CA
  • NPI 1497686091

  General Practice

  NPD Authorized official

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

{
    "created_epoch": "1691366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691366400000",
    "number": "1013690106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21856 THIMBLEBERRY CT",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928837360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23905 CLINTON KEITH RD",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957897",
            "telephone_number": "951-741-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELMESEEH",
        "first_name": "ISAIAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-07",
        "last_updated": "2023-08-07",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "109037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 1918 Winter Street Operating Co LLC
• Abdul S. Farzin M.D., Inc
• Annalisa Argente Abjelina, M.D.
• Ac Licensed Clinical Social Worker
• Sharra Ackerman
• Karla Acosta

• All providers in Wildomar, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2023; 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.