Individual provider Active NPI

Samir Rizvanbegovic, DDS

  • General Practice Dentistry
  • Palm Desert, CA
National Provider Identifier
1366609034
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47167 Issued in CA
Practice address
44421 Town Center Way Ste C
Palm Desert, CA 92260-2705
Phone
(760) 776-1646
Fax
(760) 776-1645
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 47167 CA Primary

Addresses

Primary practice location

44421 Town Center Way Ste C
Palm Desert, CA 92260-2705

Mailing address

44421 Town Center Way Ste C
Palm Desert, CA 92260-2705
Phone (760) 776-1646

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
I20161209001603 CA Order and Referring Only - DentistPractitioner - Dentist 0143500082

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
47167CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Samir Rizvanbegovic,DDS,Inc. CurrentSince Feb 2, 2020 Accepting new patients

Locations

44421 Town Center Way
Ste C
Palm Desert, CA 92260
Phone (760) 776-1646

Organizations & group practices 1

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": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1366609034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44421 TOWN CENTER WAY STE C",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602705",
            "telephone_number": "760-776-1646",
            "fax_number": "760-776-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44421 TOWN CENTER WAY STE C",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922602705",
            "telephone_number": "760-776-1646",
            "fax_number": "760-776-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZVANBEGOVIC",
        "first_name": "SAMIR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.