Individual provider Active NPI

Sahar Sepidehdam, D.D.S

  • Dentist
  • Moorpark, CA
National Provider Identifier
1134521024
Registry record updated Oct 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63552 Issued in CA
Practice address
100 W. High St. #617
Moorpark, CA 93020-1820
Phone
(213) 293-6256
NPI assigned
Sep 22, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63552 CA Primary

Addresses

Primary practice location

100 W. High St. #617
Moorpark, CA 93020-1820

Mailing address

100 W. High St. #617
Moorpark, CA 93020-1820
Phone (213) 293-6256

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
I20150811005706 CA Order and Referring Only - DentistPractitioner - Dentist 0840505467

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414454400000",
    "number": "1134521024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W. HIGH ST. #617",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930201820",
            "telephone_number": "213-293-6256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W. HIGH ST. #617",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930201820",
            "telephone_number": "213-293-6256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPIDEHDAM",
        "first_name": "SAHAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorpark, CA

Sources for this page

Verify at the official NPI Registry.