Individual provider Active NPI

Sanah Amir Sohrab, D.D.S

  • Pediatric Dentistry
  • Burbank, CA
National Provider Identifier
1225237357
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
55741 Issued in CA
Practice address
1824 W Verdugo Ave
Burbank, CA 91506-2150
Phone
(818) 566-8715
Fax
(818) 528-8784
NPI assigned
Jul 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 55741 CA Primary

Addresses

Primary practice location

1824 W Verdugo Ave
Burbank, CA 91506-2150

Mailing address

1824 West Verdugo Avenue
Burbank, CA 91506
Phone (818) 566-8715

Other identifiers 1

IdentifierTypeStateIssuer
1225237357MedicaidCA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Sanah Amir Sohrab DDS Inc Pediatric Dentistry PastSince Jul 24, 2022 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1225237357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 WEST VERDUGO AVENUE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "91506",
            "telephone_number": "818-566-8715",
            "fax_number": "818-528-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 W VERDUGO AVE",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915062150",
            "telephone_number": "818-566-8715",
            "fax_number": "818-528-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOHRAB",
        "first_name": "SANAH",
        "middle_name": "AMIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-18",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "55741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225237357",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.