Individual provider Active NPI

Oliver Kamari-Bidkorpeh, D.D.S.

  • Dentist
  • Canyon Country, CA
National Provider Identifier
1396159174
Registry record updated May 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
65294 Issued in CA
Practice address
19366 Soledad Canyon Rd
Canyon Country, CA 91351-2629
Phone
(818) 634-7285
NPI assigned
Jun 19, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 65294 CA Primary

Addresses

Primary practice location

19366 Soledad Canyon Rd
Canyon Country, CA 91351-2629

Mailing address

19366 Soledad Canyon Rd
Canyon Country, CA 91351-2629
Phone (818) 634-7285

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
I20250128000207 CA Practitioner - Dentist 7416486071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers, Inc. CurrentSince Dec 16, 2024 Accepting new patients
Comprehensive Community Health Centers, Inc CurrentSince Dec 16, 2024 Accepting new patients
Comprehensive Community Health Centers Inc Current Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

1704 Colorado Blvd
Los Angeles, CA 90041
Phone (323) 256-4116

8316 Foothill Blvd
Sunland, CA 91040
Phone (818) 273-8800

Organizations & group practices 3

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": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463356800000",
    "number": "1396159174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19366 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913512629",
            "telephone_number": "818-634-7285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19366 SOLEDAD CANYON RD",
            "city": "CANYON COUNTRY",
            "state": "CA",
            "postal_code": "913512629",
            "telephone_number": "818-634-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMARI-BIDKORPEH",
        "first_name": "OLIVER",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-19",
        "last_updated": "2016-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "65294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canyon Country, CA

Sources for this page

Verify at the official NPI Registry.