Individual provider Active NPI

Fatemeh S. Sadrieh, DDS

  • General Practice Dentistry
  • Sherman Oaks, CA
National Provider Identifier
1508945585
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
33362 Issued in CA
Practice address
4910 Van Nuys Blvd
Suite 110
Sherman Oaks, CA 91403-1782
Phone
(818) 986-3461
Fax
(818) 986-9582
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 33362 CA Primary

Addresses

Primary practice location

4910 Van Nuys Blvd
Suite 110
Sherman Oaks, CA 91403-1782

Mailing address

1029 Glenhaven Dr
Pacific Palisades, CA 90272-2204
Phone (818) 986-3461

Other identifiers 2

IdentifierTypeStateIssuer
B33362-01MedicaidCA
33362OtherCASTATE LICENSE #

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508945585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 GLENHAVEN DR",
            "city": "PACIFIC PALISADES",
            "state": "CA",
            "postal_code": "902722204",
            "telephone_number": "818-986-3461",
            "fax_number": "818-986-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD",
            "address_2": "SUITE 110",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031782",
            "telephone_number": "818-986-3461",
            "fax_number": "818-986-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADRIEH",
        "first_name": "FATEMEH",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "33362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B33362-01",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "33362",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.