Individual provider Active NPI

Ossama Murad Safar, DMD

  • Pediatric Dentistry
  • Glendora, CA
National Provider Identifier
1235118969
Registry record updated Feb 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
55303 Issued in CA
Practice address
641 W Route 66
Suite E
Glendora, CA 91740-4149
Phone
(909) 896-0509
Fax
(813) 762-1800
NPI assigned
Jan 11, 2006
Last updated
Feb 2, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DN16436 FL
Pediatric Dentistry 1223P0221X 55303 CA Primary

Addresses

Primary practice location

641 W Route 66
Suite E
Glendora, CA 91740-4149

Mailing address

641 W Route 66
Suite E
Glendora, CA 91740-4149
Phone (909) 896-0509

Other identifiers 1

IdentifierTypeStateIssuer
075936800MedicaidFL

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
DN16436FLMDPediatric Dentist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233532800000",
    "number": "1235118969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "641 W ROUTE 66",
            "address_2": "SUITE E",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404149",
            "telephone_number": "909-896-0509",
            "fax_number": "813-762-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W ROUTE 66",
            "address_2": "SUITE E",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917404149",
            "telephone_number": "909-896-0509",
            "fax_number": "813-762-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFAR",
        "first_name": "OSSAMA",
        "middle_name": "MURAD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2009-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN16436",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "55303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "075936800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2009; 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.