Individual provider Active NPI

Fabiola Bachman, DDS

  • Dentist
  • Burbank, CA
National Provider Identifier
1205387446
Registry record updated Oct 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
100965 Issued in CA
Practice address
138 N Pass Ave
2
Burbank, CA 91505
Phone
(925) 980-1391
NPI assigned
Oct 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 100965 CA Primary

Addresses

Primary practice location

138 N Pass Ave
2
Burbank, CA 91505

Mailing address

138 N Pass Ave
2
Burbank, CA 91505-4242
Phone (925) 980-1391

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
I20170421001002 CA Order and Referring Only - DentistPractitioner - Dentist 3870879141

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100965CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477267200000",
    "number": "1205387446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 N PASS AVE",
            "address_2": "2",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915054242",
            "telephone_number": "925-980-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 N PASS AVE",
            "address_2": "2",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91505",
            "telephone_number": "925-980-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHMAN",
        "first_name": "FABIOLA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

Verify at the official NPI Registry.