Individual provider Active NPI

Rafeeq Naina Rahman, D.D.S.

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1124293543
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
55809 Issued in CA
Practice address
1761 W Romneya Dr Ste J
Anaheim, CA 92801-1816
Phone
(714) 635-6300
NPI assigned
Apr 26, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 55809 CA Primary
General Practice Dentistry 1223G0001X D9154 OR

Addresses

Primary practice location

1761 W Romneya Dr Ste J
Anaheim, CA 92801-1816

Mailing address

285 E California Blvd
Apt 105
Pasadena, CA 91106-3689
Phone (718) 404-6128

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
55809CAMDGeneral Practice Dentistry
D9154ORMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1209168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1124293543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 E CALIFORNIA BLVD",
            "address_2": "APT 105",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911063689",
            "telephone_number": "718-404-6128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 W ROMNEYA DR STE J",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011816",
            "telephone_number": "714-635-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "RAFEEQ",
        "middle_name": "NAINA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-26",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55809",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.