Individual provider Active NPI

Ahmad Sadeghein, D.D.S.

  • Endodontics
  • Glendale, CA
National Provider Identifier
1114005030
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
36219 Issued in CA
Practice address
500 N Central Ave
750
Glendale, CA 91203-3905
Phone
(818) 551-5055
Fax
(818) 246-2463
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 36219 CA Primary

Addresses

Primary practice location

500 N Central Ave
750
Glendale, CA 91203-3905

Mailing address

500 N Central Ave
750
Glendale, CA 91203-3905
Phone (818) 551-5055

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
I20160216001283 CA Order and Referring Only - DentistPractitioner - Dentist 8921303728

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmad Sadeghein DDS Inc Endodontics CurrentSince Dec 15, 2024 Accepting new patients

Locations

500 N Central Ave
Ste 750
Glendale, CA 91203
Phone (818) 551-5055

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1114005030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N CENTRAL AVE",
            "address_2": "750",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033905",
            "telephone_number": "818-551-5055",
            "fax_number": "818-246-2463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N CENTRAL AVE",
            "address_2": "750",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912033905",
            "telephone_number": "818-551-5055",
            "fax_number": "818-246-2463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADEGHEIN",
        "first_name": "AHMAD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "36219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.