Individual provider Active NPI

Hossein Abdolhosseini, D.D.S.

  • General Practice Dentistry
  • Chino Hills, CA
National Provider Identifier
1093853020
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50715 Issued in CA
Practice address
5771 Pine Ave
Suite S
Chino Hills, CA 91709
Phone
(909) 597-2477
Fax
(909) 597-3772
NPI assigned
Feb 2, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 50715 CA Primary

Addresses

Primary practice location

5771 Pine Ave
Suite S
Chino Hills, CA 91709

Mailing address

5715 Larry Dean St
Corona, CA 92880-3151
Phone (909) 947-3063

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
I20191122002351 CA Practitioner - Oral SurgeryPractitioner - Dentist 8224460662

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gupta Gill Abdolhosseini DDS Inc General Practice PastSince Sep 14, 2019 Accepting new patients

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": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093853020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5715 LARRY DEAN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928803151",
            "telephone_number": "909-947-3063",
            "fax_number": "909-947-3063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5771 PINE AVE",
            "address_2": "SUITE S",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "91709",
            "telephone_number": "909-597-2477",
            "fax_number": "909-597-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDOLHOSSEINI",
        "first_name": "HOSSEIN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.