Active NPI
Maged Fares Wahba, DDS
- Dentist
- Van Nuys, CA
National Provider Identifier
1245425255
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36461
- Practice address
- 7120 Hayvenhurst Ave
Suite 205
Van Nuys, CA 91406 - Phone
- (818) 988-1642
- Fax
- (818) 988-0771
- NPI assigned
- Sep 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 36461 | CA | Primary |
Addresses
Primary practice location
7120 Hayvenhurst Ave
Suite 205
Van Nuys, CA 91406
Mailing address
7120 Hayvenhurst Ave
Suite 205
Van Nuys, CA 91406
Phone (818) 988-1642
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
| License | State | Type | Specialty |
|---|---|---|---|
| 36461 | CA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wahba Dental Corp | Dentist | 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.
-
- Dentist
- Van Nuys, CA
- NPI 1477642957
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189555200000",
"number": "1245425255",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7120 HAYVENHURST AVE",
"address_2": "SUITE 205",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "91406",
"telephone_number": "818-988-1642",
"fax_number": "818-988-0771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7120 HAYVENHURST AVE",
"address_2": "SUITE 205",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "91406",
"telephone_number": "818-988-1642",
"fax_number": "818-988-0771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WAHBA",
"first_name": "MAGED",
"middle_name": "FARES",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-12",
"last_updated": "2007-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "36461",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.