Organization Active NPI

A. M. Ashtiani, a Professional Corporation

Doing business as North Bridge Endodontics

  • Endodontics
  • Petaluma, CA
National Provider Identifier
1164612446
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
38081 Issued in CA
Legal business name
A. M. ASHTIANI, A PROFESSIONAL CORPORATION
Doing business as
North Bridge Endodontics
Practice address
30 W El Rose Dr
Petaluma, CA 94952-7525
Phone
(707) 789-9399
Fax
(707) 789-9199
NPI assigned
Aug 1, 2007
Last updated
Mar 21, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Authorized official

Name
Dr. Andy A . M. Ashtiani, D.D.S.NPI 1982721437
Title
President
Phone
(707) 789-9399

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
Endodontics 1223E0200X 38081 CA Primary

Addresses

Primary practice location

30 W El Rose Dr
Petaluma, CA 94952-7525

Mailing address

30 W El Rose Dr
Petaluma, CA 94952-7525
Phone (707) 789-9399

Other names 1

  • North Bridge Endodontics Doing business as

National Provider Directory

National Provider Directory

Locations

30 W El Rose Dr
Petaluma, CA 94952
Phone (707) 763-3203

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": "1185926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1164612446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W EL ROSE DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527525",
            "telephone_number": "707-789-9399",
            "fax_number": "707-789-9199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W EL ROSE DR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949527525",
            "telephone_number": "707-789-9399",
            "fax_number": "707-789-9199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A. M. ASHTIANI, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-01",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "ASHTIANI",
        "authorized_official_first_name": "ANDY",
        "authorized_official_middle_name": "A . M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-789-9399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "38081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Bridge Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.