Active NPI
Negar Tabandeh, DDS, MS
- Periodontics
- Upland, CA
National Provider Identifier
1366644916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 48032
- Practice address
- 440 N Mountain Ave
Upland, CA 91786-5183 - Phone
- (909) 949-2881
- Fax
- (909) 949-0621
- NPI assigned
- Jun 5, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 48032 | CA | Primary |
Addresses
Primary practice location
440 N Mountain Ave
Upland, CA 91786-5183
Mailing address
4010 Prado de Las Frutas
Calabasas, CA 91302-3640
Phone (818) 222-5670
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150910002349 | CA | Order and Referring Only - Dentist | 2668789462 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48032 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1366644916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 PRADO DE LAS FRUTAS",
"city": "CALABASAS",
"state": "CA",
"postal_code": "913023640",
"telephone_number": "818-222-5670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "440 N MOUNTAIN AVE",
"city": "UPLAND",
"state": "CA",
"postal_code": "917865183",
"telephone_number": "909-949-2881",
"fax_number": "909-949-0621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TABANDEH",
"first_name": "NEGAR",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "48032",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.