Active NPI
Gideon Saidara
- Dentist
- Lancaster, CA
National Provider Identifier
1306663414
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 110766
- Practice address
- 2030 W Avenue J
Lancaster, CA 93536-5913 - Phone
- (661) 949-6757
- NPI assigned
- Sep 21, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 | 110766 | CA | Primary |
Addresses
Primary practice location
2030 W Avenue J
Lancaster, CA 93536-5913
Mailing address
806 N Linden Dr
Beverly Hills, CA 90210-3008
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 |
|---|---|---|---|
| 110766 | CA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gideon Saidara DDS, Inc. | Current | Accepting new patients | |
| Lancaster Dental Care Assoc | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Palmdale, CA
- NPI 1841120904
-
- General Practice Dentistry
- Lancaster, CA
- NPI 1770606519
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1726876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726876800000",
"number": "1306663414",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "806 N LINDEN DR",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902103008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2030 W AVENUE J",
"city": "LANCASTER",
"state": "CA",
"postal_code": "935365913",
"telephone_number": "661-949-6757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAIDARA",
"first_name": "GIDEON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-21",
"last_updated": "2024-09-21",
"certification_date": "2024-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "110766",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lancaster, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.