Active NPI
Mohammad Bustati, DDS
- Dentist
- Lancaster, CA
National Provider Identifier
1174612154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 51235
- Practice address
- 1228 W Avenue K
Lancaster, CA 93534-5922 - Phone
- (661) 949-3152
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 51235 | CA | Primary |
Addresses
Primary practice location
1228 W Avenue K
Lancaster, CA 93534-5922
Mailing address
43126 30TH St W
Apt 129
Lancaster, CA 93536-4701
Phone (714) 588-6042
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161019002000 | CA | Order and Referring Only - Oral Surgery | 0042508301 |
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": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174612154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43126 30TH ST W",
"address_2": "APT 129",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935364701",
"telephone_number": "714-588-6042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1228 W AVENUE K",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935345922",
"telephone_number": "661-949-3152"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTATI",
"first_name": "MOHAMMAD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "51235",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.