NPIMap

Organization Active NPI

Thousand Oaks Childrens Dental Group

  • Pediatric Dentistry
  • Thousand Oaks, CA
National Provider Identifier
1124140751
Registry record updated Feb 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
036029 Issued in CA
Legal business name
THOUSAND OAKS CHILDRENS DENTAL GROUP
Practice address
61 Long CT
Suite 202
Thousand Oaks, CA 91360
Phone
(805) 497-3797
Fax
(805) 371-1121
NPI assigned
Apr 4, 2007
Last updated
Feb 4, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2009

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

Authorized official

Name
Mr. Ahsan S Raza, D.D.S.NPI 1699897512
Title
Owner/Partner
Phone
(805) 497-3797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 036029 CA Primary

Addresses

Primary practice location

61 Long CT
Suite 202
Thousand Oaks, CA 91360

Mailing address

61 Long CT
Suite 202
Thousand Oaks, CA 91360
Phone (805) 497-3797

National Provider Directory

National Provider Directory

Locations

61 Long Ct
Ste 202
Thousand Oaks, CA 91360
Phone (805) 497-3797

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1124140751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LONG CT",
            "address_2": "SUITE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-497-3797",
            "fax_number": "805-371-1121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 LONG CT",
            "address_2": "SUITE 202",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "91360",
            "telephone_number": "805-497-3797",
            "fax_number": "805-371-1121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOUSAND OAKS CHILDRENS DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "RAZA",
        "authorized_official_first_name": "AHSAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "805-497-3797",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "036029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.