Sambath Tiep DDS, PC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

SAMBATH TIEP DDS, PC

Practice address

15725 Pomerado Rd Ste 206
Poway, CA 92064-2059

Phone

(858) 251-3313

Fax

(858) 225-1803

NPI assigned

Nov 4, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sambath Tiep, DDSNPI 1598093643

Title

Owner/President

Phone

(858) 251-3313

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sambath Sem Tiep, D.D.S.

  • Pediatric Dentistry
  • Poway, CA
  • NPI 1598093643
  NPD Authorized official

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

{
    "created_epoch": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1548804313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD STE 206",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642059",
            "telephone_number": "858-251-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15725 POMERADO RD STE 206",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642059",
            "telephone_number": "858-251-3313",
            "fax_number": "858-225-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMBATH TIEP DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "TIEP",
        "authorized_official_first_name": "SAMBATH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "858-251-3313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Poway, CA
• Providers in Poway, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2020; 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.