Individual provider Active NPI

Bobby Soleiman, DDS

  • Periodontics
  • Murrieta, CA
National Provider Identifier
1497863534
Registry record updated Jun 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
43860 Issued in CA
Practice address
40770 California Oaks Rd
Murrieta, CA 92562-5727
Phone
(951) 677-3078
Fax
(951) 600-0498
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2017

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 00202465 CO
Periodontics 1223P0300X S4-61C NV
Periodontics 1223P0300X DE60568675 WA
Periodontics 1223P0300X D10296 OR
Periodontics 1223P0300X 9578186-9921 UT
Periodontics 1223P0300X S128 MN
Periodontics 1223P0300X 2017011750 MO
Periodontics 1223P0300X 43860 CA Primary
Prosthodontics 1223P0700X 61328 KS

Addresses

Primary practice location

40770 California Oaks Rd
Murrieta, CA 92562-5727

Mailing address

2345 Stratford Cir
2ND Floor
Los Angeles, CA 90077-1318
Phone (818) 389-7288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20150804006034 NV Order and Referring Only - DentistPractitioner - Dentist 3274847264

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
43860CAMDMental Health Counselor
00202465COMDPeriodontist
S128MNMDPeriodontist
2017011750MOMDPeriodontist
D10296ORMDPeriodontist
9578186-9921UTMDPeriodontist
DE60568675WAMDPeriodontist
61328KSMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496880000000",
    "number": "1497863534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 STRATFORD CIR",
            "address_2": "2ND FLOOR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771318",
            "telephone_number": "818-389-7288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40770 CALIFORNIA OAKS RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625727",
            "telephone_number": "951-677-3078",
            "fax_number": "951-600-0498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLEIMAN",
        "first_name": "BOBBY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2017-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "00202465",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NV",
            "license": "S4-61C",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE60568675",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D10296",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "UT",
            "license": "9578186-9921",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "S128",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MO",
            "license": "2017011750",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "43860",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "KS",
            "license": "61328",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.