Individual provider Active NPI

Astrid Soegaard, D.M.D.

  • General Practice Dentistry
  • La Canada, CA
National Provider Identifier
1245397355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
38364 Issued in CA
Practice address
747 Foothill Blvd
Suite 2
La Canada, CA 91011-3438
Phone
(818) 790-5531
Fax
(818) 790-5533
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

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 38364 CA Primary

Addresses

Primary practice location

747 Foothill Blvd
Suite 2
La Canada, CA 91011-3438

Mailing address

747 Foothill Blvd
Suite 2
La Canada, CA 91011
Phone (818) 790-5531

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
I20160203001316 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507160090

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Astrid Soegaard D.M.D., Inc. General Practice Past 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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245397355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 FOOTHILL BLVD",
            "address_2": "SUITE 2",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "91011",
            "telephone_number": "818-790-5531",
            "fax_number": "818-790-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 FOOTHILL BLVD",
            "address_2": "SUITE 2",
            "city": "LA CANADA",
            "state": "CA",
            "postal_code": "910113438",
            "telephone_number": "818-790-5531",
            "fax_number": "818-790-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOEGAARD",
        "first_name": "ASTRID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "38364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Canada, CA

Sources for this page

Verify at the official NPI Registry.