Individual provider Active NPI

Arnold R Rudman, D.D.S.

  • General Practice Dentistry
  • Thousand Oaks, CA
National Provider Identifier
1174656383
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24332 Issued in CA
Practice address
2220 Lynn Rd
Suite 305
Thousand Oaks, CA 91360-1904
Phone
(805) 497-3749
Fax
(805) 497-3740
NPI assigned
Mar 14, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 24332 CA Primary

Addresses

Primary practice location

2220 Lynn Rd
Suite 305
Thousand Oaks, CA 91360-1904

Mailing address

2220 Lynn Rd
Suite 305
Thousand Oaks, CA 91360-1904
Phone (805) 497-3749

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
24332CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174656383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD",
            "address_2": "SUITE 305",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601904",
            "telephone_number": "805-497-3749",
            "fax_number": "805-497-3740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD",
            "address_2": "SUITE 305",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601904",
            "telephone_number": "805-497-3749",
            "fax_number": "805-497-3740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDMAN",
        "first_name": "ARNOLD",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.