Individual provider Active NPI

Negar Zareh, DDS

  • General Practice Dentistry
  • Tustin, CA
National Provider Identifier
1063569499
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49257 Issued in CA
Practice address
13830 Red Hill Ave
Tustin, CA 92780-4637
Phone
(714) 832-1730
Fax
(714) 832-1540
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 49257 CA Primary

Addresses

Primary practice location

13830 Red Hill Ave
Tustin, CA 92780-4637

Mailing address

13830 Red Hill Ave
Tustin, CA 92780-4637
Phone (714) 832-1730

Other identifiers 1

IdentifierTypeStateIssuer
G92535-01MedicaidCA

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
I20200309001935 CA Practitioner - Oral SurgeryPractitioner - Dentist 6507294386

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49257CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063569499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13830 RED HILL AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804637",
            "telephone_number": "714-832-1730",
            "fax_number": "714-832-1540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13830 RED HILL AVE",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927804637",
            "telephone_number": "714-832-1730",
            "fax_number": "714-832-1540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAREH",
        "first_name": "NEGAR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G92535-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tustin, CA

Sources for this page

Verify at the official NPI Registry.