Rohin Ambaram

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

100021 Issued in CA

Practice address

19100 Ventura Blvd Ste 3
Tarzana, CA 91356-3234

Phone

(916) 517-3481

NPI assigned

Apr 9, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 19, 2024 through Jul 19, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rambarham366974@direct.hfhs.org

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.

• Huss Dental Corporation

  • General Practice Dentistry
  • Newbury Park, CA
  • NPI 1508204967
  NPD (past)
• VHS Physicians of Michigan

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1457747123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 AUTUMN LEAF DR",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913602607",
            "telephone_number": "916-517-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19100 VENTURA BLVD STE 3",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563234",
            "telephone_number": "916-517-3481"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Park Place Dental Group",
            "address_2": "501 S Reino Rd, Ste G",
            "address_purpose": "LOCATION",
            "city": "Newbury Park",
            "state": "CA",
            "postal_code": "91320",
            "country_code": "US",
            "telephone_number": "805-499-4441",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4201 Saint Antoine St",
            "address_2": "UHC 2F",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482012153",
            "country_code": "US",
            "telephone_number": "313-745-4622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AMBARAM",
        "first_name": "ROHIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "100021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge A Alvarez, D.D.S.
• Nathan Alyesh
• Khaled Alzaabi, MS, BCBA
• Ama Clinic Inc
• Brianda Carolina Amaya Rivas
• Jim Amerian, M.D.
• American Regal Home Care
• American Regal Trans Inc
• American Standard Home Health
• American Urgent Care Center Inc

• Oral and Maxillofacial Surgery (Dentist) in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.