Individual provider Active NPI

Katayoun Sahafi DDS Professional Corp

  • General Practice Dentistry
  • Newport Beach, CA
National Provider Identifier
1255430765
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
49658 Issued in CA
Practice address
601 Dover Dr Ste 5
Newport Beach, CA 92663-5721
Phone
(949) 548-0966
Fax
(949) 548-9796
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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 49658 CA Primary

Addresses

Primary practice location

601 Dover Dr Ste 5
Newport Beach, CA 92663-5721

Mailing address

601 Dover Dr Ste 5
Newport Beach, CA 92663-5721
Phone (949) 548-0966

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
I20160517001899 CA Order and Referring Only - DentistPractitioner - Dentist 3274822119

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Katayoun Sahafi DDS Professional Corp PastSince Jun 1, 2004 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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1255430765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 DOVER DR STE 5",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635721",
            "telephone_number": "949-548-0966",
            "fax_number": "949-548-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 DOVER DR STE 5",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926635721",
            "telephone_number": "949-548-0966",
            "fax_number": "949-548-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAHAFI DDS PROFESSIONAL CORP",
        "first_name": "KATAYOUN",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

Verify at the official NPI Registry.