Individual provider Active NPI

Niousha Saghafi, DDS, MSD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fairfield, CA
National Provider Identifier
1275994154
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DDS100806 Issued in CA
Practice address
1411 Oliver Rd Ste 330
Fairfield, CA 94534-3425
Phone
(707) 428-3200
NPI assigned
Mar 18, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DDS100806 CA Primary

Addresses

Primary practice location

1411 Oliver Rd Ste 330
Fairfield, CA 94534-3425

Mailing address

2321 Banbury Loop
Martinez, CA 94553-6703
Phone (818) 430-1083

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
I20170117001923 CA Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6800178476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS100806CAMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Niousha Saghafi, DDS, MSD, Inc. Orthodontics and Dentofacial Orthopedics CurrentSince Jun 1, 2023 Accepting new patients
Nancy H. Le, DDS, Ms, Inc. Orthodontics and Dentofacial Orthopedics PastSince Jun 1, 2023 Accepting new patients

Locations

1411 Oliver Rd
Ste 330
Fairfield, CA 94534
Phone (707) 428-3200

Organizations & group practices 2

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1275994154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 BANBURY LOOP",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945536703",
            "telephone_number": "818-430-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 OLIVER RD STE 330",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945343425",
            "telephone_number": "707-428-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAGHAFI",
        "first_name": "NIOUSHA",
        "credential": "DDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-18",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "DDS100806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

Verify at the official NPI Registry.