Sam Baradaran, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

101275 Issued in CA

Practice address

16440 Vanowen St
Van Nuys, CA 91406-4729

Phone

(818) 447-0098

NPI assigned

Apr 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sam Baradaran DDS Inc

  • General Practice Dentistry
  • Van Nuys, CA
  • NPI 1831782267
  NPD Authorized official

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1235663642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16440 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064729",
            "telephone_number": "818-447-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16440 VANOWEN ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914064729",
            "telephone_number": "818-447-0098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16440 Vanowen St",
            "address_purpose": "LOCATION",
            "city": "Lake Balboa",
            "state": "CA",
            "postal_code": "914064729",
            "country_code": "US",
            "telephone_number": "818-779-4900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARADARAN",
        "first_name": "SAM",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "101275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Balyezyan, NURSE PRACTITIONER
• Breanda Banoth
• Emilio Banuelos
• Karina Banuelos
• Michael Mehrdad Baradaran, DMD
• Maria Rosario Barajas Ceballos I
• Cassandra Gonzalez Barajas
• Jessica Barajas
• Jessica Barajas
• Lili Marlene Barajas, PA-C

• General Practice Dentistry in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.