Jalil A Babagoli, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49463 Issued in CA

Practice address

330 Park Ave
Suite # 8
Laguna Beach, CA 92651-2352

Phone

(949) 376-3400

Fax

(949) 376-3404

NPI assigned

May 7, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 29, 2015 through Jun 29, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326251570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "SUITE # 8",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "949-376-3400",
            "fax_number": "949-376-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 PARK AVE",
            "address_2": "SUITE # 8",
            "city": "LAGUNA BEACH",
            "state": "CA",
            "postal_code": "926512352",
            "telephone_number": "949-376-3400",
            "fax_number": "949-376-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABAGOLI",
        "first_name": "JALIL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Awaken Insight Counseling Licensed Clinical Social Worker PC (Awaken Insight Counseling)
• Abir Ayesh, LMFT
• Thomas Lee Baba, DDS
• Joe Baker, D.M.D.
• Rebekah Ballard, DDS
• Jennifer Lynn Ballew, CD
• Eric William Banducci
• Josephine Bang

• General Practice Dentistry in Laguna Beach, CA
• Providers in Laguna Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.