Individual provider Active NPI

Amani Soliman, D.D.S.

  • Dentist
  • Lake Forest, CA
National Provider Identifier
1265637342
Registry record updated Jan 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40018 Issued in CA
Practice address
23591 El Toro Rd
Suite # 130
Lake Forest, CA 92630-4774
Phone
(949) 597-8808
Fax
(949) 597-8911
NPI assigned
Jun 18, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40018 CA Primary

Addresses

Primary practice location

23591 El Toro Rd
Suite # 130
Lake Forest, CA 92630-4774

Mailing address

23591 El Toro Rd
Suite # 130
Lake Forest, CA 92630-4774
Phone (949) 597-8808

Other identifiers 1

IdentifierTypeStateIssuer
D40018OtherCAMEDICAL

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
I20151125000715 CA Order and Referring Only - DentistPractitioner - Dentist 4981904869

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amani Soliman D.D.S,Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263427200000",
    "number": "1265637342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23591 EL TORO RD",
            "address_2": "SUITE # 130",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304774",
            "telephone_number": "949-597-8808",
            "fax_number": "949-597-8911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23591 EL TORO RD",
            "address_2": "SUITE # 130",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926304774",
            "telephone_number": "949-597-8808",
            "fax_number": "949-597-8911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIMAN",
        "first_name": "AMANI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-18",
        "last_updated": "2010-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "D40018",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

Verify at the official NPI Registry.