Ninousha Basti, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

55294 Issued in CA

Practice address

150 Avendia del Mar, Ste. C
San Clemente, CA 92672

Phone

(949) 347-0780

Fax

(949) 347-9549

NPI assigned

Mar 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nina Basti DDS, Inc

  • Dentist
  • San Clemente, CA
  • NPI 1578985297
  NPD (past) Authorized official

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1164551800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 AVENIDA DEL MAR, STE. C",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92672",
            "telephone_number": "949-492-0330",
            "fax_number": "949-492-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 AVENDIA DEL MAR, STE. C",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "92672",
            "telephone_number": "949-347-0780",
            "fax_number": "949-347-9549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTI",
        "first_name": "NINOUSHA",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "55294",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Molina Barbanell, P.T.
• Karen Taylor Barnes, PTA
• Taylor Paige Barragan-Bareng, B.S., SLPA
• Gilbert Ruiz Barrera Jr., IDC
• Steven Bartz, D.C.
• Abbie Kim Bates, DNP
• Isabela Fortes Baumgardner, FDN-P, CIYT, CYT
• Casey Noelle Bautista, RD
• Lauren Bautista
• Nada Isahiejeva Baytala, LMFT

• All providers in San Clemente, CA
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.