Individual provider Active NPI

Siamak Okhovat, DDS

  • General Practice Dentistry
  • Roseville, CA
National Provider Identifier
1538266499
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
47541 Issued in CA
Practice address
2110 Professional Dr
Suite 115
Roseville, CA 95661-3752
Phone
(916) 783-5600
NPI assigned
Sep 20, 2006
Last updated
May 27, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2011

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 47541 CA Primary

Addresses

Primary practice location

2110 Professional Dr
Suite 115
Roseville, CA 95661-3752

Mailing address

7136 Artisan Cir
Roseville, CA 95678-2906
Phone (916) 765-2054

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

LicenseStateTypeSpecialty
47541CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Okhovat Dental Practice of Auburn Current Accepting new patients
Okhovat Professional Dental General Practice Past Accepting new patients

Organizations & group practices 2

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1538266499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 ARTISAN CIR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782906",
            "telephone_number": "916-765-2054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 PROFESSIONAL DR",
            "address_2": "SUITE 115",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613752",
            "telephone_number": "916-783-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OKHOVAT",
        "first_name": "SIAMAK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.