NPIMap

Organization Active NPI

Saman Ghaemmaghami DMD a Professional Dental Corporation

  • General Practice Dentistry
  • San Bernardino, CA
National Provider Identifier
1104420157
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
SAMAN GHAEMMAGHAMI DMD A PROFESSIONAL DENTAL CORPORATION
Practice address
4016 University Pkwy
San Bernardino, CA 92407-1821
Phone
(909) 880-1600
NPI assigned
Nov 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Saman Ghaemmaghami, DMDNPI 1013432913
Title
Ceo
Phone
(408) 930-4970

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

4016 University Pkwy
San Bernardino, CA 92407-1821

Mailing address

11540 Claridge Dr
Rancho Cucamonga, CA 91730-7244

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1104420157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11540 CLARIDGE DR",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4016 UNIVERSITY PKWY",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924071821",
            "telephone_number": "909-880-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMAN GHAEMMAGHAMI DMD A PROFESSIONAL DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-30",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "GHAEMMAGHAMI",
        "authorized_official_first_name": "SAMAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-930-4970",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.