Individual provider Active NPI

Farid Tebyani, DDS

  • General Practice Dentistry
  • Thousand Oaks, CA
National Provider Identifier
1063571198
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53485 Issued in CA
Practice address
3180 Willow LN Ste 208
Thousand Oaks, CA 91361-4988
Phone
(805) 230-1900
Fax
(805) 230-1912
NPI assigned
Dec 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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 53485 CA Primary

Addresses

Primary practice location

3180 Willow LN Ste 208
Thousand Oaks, CA 91361-4988

Mailing address

3180 Willow LN Ste 208
Thousand Oaks, CA 91361-4988
Phone (805) 230-1900

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
I20250913000582 CA Practitioner - Dentist 0042713141 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1994
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3180 Willow LN
Suite 208
Thousand Oaks, CA 91361-4988

5223 Kennedy Cres
Sanborn, NY 14132-9463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53485CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Farid Tebyani, D.D.S., Inc. General Practice CurrentSince Jul 22, 2025 Accepting new patients

Locations

3180 Willow Ln
Ste 208
Thousand Oaks, CA 91361
Phone (805) 230-1900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1063571198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614988",
            "telephone_number": "805-230-1900",
            "fax_number": "805-230-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN STE 208",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614988",
            "telephone_number": "805-230-1900",
            "fax_number": "805-230-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEBYANI",
        "first_name": "FARID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.