Individual provider Active NPI

Taleen Judy Davidian, DDS

  • General Practice Dentistry
  • Chino Hills, CA
National Provider Identifier
1376216002
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106601 Issued in CA
Practice address
15850 Soquel Canyon Pkwy Ste a
Chino Hills, CA 91709-5874
Phone
(909) 375-0133
NPI assigned
Jul 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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 106601 CA Primary

Addresses

Primary practice location

15850 Soquel Canyon Pkwy Ste a
Chino Hills, CA 91709-5874

Mailing address

8347 Hillrose St
Sunland, CA 91040-2405
Phone (818) 618-3897

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
I20211025000757 CA Order and Referring Only - DentistPractitioner - Dentist 7012305006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Qurban Dental Corproation General Practice PastSince Aug 1, 2021 Accepting new patients

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": "1627430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627430400000",
    "number": "1376216002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8347 HILLROSE ST",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910402405",
            "telephone_number": "818-618-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15850 SOQUEL CANYON PKWY STE A",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917095874",
            "telephone_number": "909-375-0133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIDIAN",
        "first_name": "TALEEN",
        "middle_name": "JUDY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.