Active NPI
Ziad Tedini, DDS
- Dentist
- San Diego, CA
National Provider Identifier
1407868664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 57199
- Practice address
- 11230 Sorrento Valley Rd Ste 130
San Diego, CA 92121-1338 - Phone
- (858) 485-9126
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D11741 | MN | |
| Dentist | 122300000X | 57199 | CA | Primary |
Addresses
Primary practice location
11230 Sorrento Valley Rd Ste 130
San Diego, CA 92121-1338
Mailing address
11230 Sorrento Valley Rd Ste 130
San Diego, CA 92121-1338
Phone (858) 485-9126
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 984684100 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57199 | CA | MD | Dentist |
| D11741 | MN | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1368576000000",
"number": "1407868664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11230 SORRENTO VALLEY RD STE 130",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211338",
"telephone_number": "858-485-9126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11230 SORRENTO VALLEY RD STE 130",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921211338",
"telephone_number": "858-485-9126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEDINI",
"first_name": "ZIAD",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2013-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D11741",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "57199",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "984684100",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.