Hessam S Siavash, DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

59781 Issued in CA

Practice address

5200 Telegraph Rd Ste B
Ventura, CA 93003-4185

Phone

(805) 648-5121

NPI assigned

Feb 15, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 12, 2024 through Jan 12, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1316080450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 TELEGRAPH RD STE B",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930034185",
            "telephone_number": "805-648-5121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 TELEGRAPH RD STE B",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930034185",
            "telephone_number": "805-648-5121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAVASH",
        "first_name": "HESSAM",
        "middle_name": "S",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "59781",
            "primary": true
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "A124710",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Shteyman, MD
• Shih-Yu Steven Shu, MS-PPS
• Demi Shugrue
• Shyam Krishnan DDS a Professional Dental Organization
• Shyam M Krishnan DDS Inc
• Emmanuel Santos Sibal, LVN
• Christopher Charles Siciliano, PSY.D.
• Hanita Sidana, D.M.D.
• Velvet Lefaye Siddell
• Melanie M. Sierra, CADC II-CS

• Oral and Maxillofacial Surgery (Dentist) in Ventura, CA
• Providers in Ventura, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.