Organization Active NPI

Mattbahardds Inc

  • General Practice Dentistry
  • Simi Valley, CA
National Provider Identifier
1336937291
Registry record updated Apr 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MATTBAHARDDS INC
Practice address
2486 Erringer Rd # 11
Simi Valley, CA 93065-2351
Phone
(805) 520-0100
NPI assigned
Apr 29, 2025
Last updated
Apr 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2025

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

Authorized official

Name
Matt Bahar, DDSNPI 1790474450
Title
Dentist
Phone
(818) 300-6041

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

2486 Erringer Rd # 11
Simi Valley, CA 93065-2351

Mailing address

2486 Erringer Rd # 11
Simi Valley, CA 93065-2351
Phone (805) 520-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250729004368 CA Part B Supplier - Clinic/Group Practice 0042727562 Receives reassigned benefits from 1 practitioner
Practice locations: Simi Valley, CA

National Provider Directory

National Provider Directory

Locations

2486 Erringer Rd
Simi Valley, CA 93065
Phone (805) 520-0100

2486 Erringer Rd
#11
Simi Valley, CA 93065
Phone (805) 520-0100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745884800000",
    "number": "1336937291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2486 ERRINGER RD # 11",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652351",
            "telephone_number": "805-520-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2486 ERRINGER RD # 11",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652351",
            "telephone_number": "805-520-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTBAHARDDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-04-29",
        "certification_date": "2025-04-29",
        "status": "A",
        "authorized_official_last_name": "BAHAR",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "818-300-6041",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.