Individual provider Active NPI

Eddie Karabidian

  • General Practice Dentistry
  • Anaheim, CA
National Provider Identifier
1487139879
Registry record updated Jan 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
103261 Issued in CA
Practice address
1520 E Lincoln Ave
Anaheim, CA 92805-2261
Phone
(818) 640-4848
NPI assigned
Oct 1, 2018
Last updated
Jan 4, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2022

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 103261 CA Primary

Addresses

Primary practice location

1520 E Lincoln Ave
Anaheim, CA 92805-2261

Mailing address

521 E Garfield Ave Apt 5
Glendale, CA 91205-2882
Phone (818) 681-1428

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
I20220110000963 CA Practitioner - Oral SurgeryPractitioner - Dentist 7012309750

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103261CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sahabi D D S Dental Corporation General Practice CurrentSince Oct 6, 2021 Accepting new patients

Locations

4701 Eagle Rock Blvd
Los Angeles, CA 90041
Phone (323) 255-5572

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1487139879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E GARFIELD AVE APT 5",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912052882",
            "telephone_number": "818-681-1428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E LINCOLN AVE",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928052261",
            "telephone_number": "818-640-4848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KARABIDIAN",
        "first_name": "EDDIE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-01",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "103261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.