Individual provider Active NPI

Megan Kaye Matibag Maghiran, DMD

  • General Practice Dentistry
  • Rancho Cucamonga, CA
National Provider Identifier
1568296473
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110600 Issued in CA
Practice address
11819 Foothill Blvd Ste G
Rancho Cucamonga, CA 91730-3939
Phone
(909) 476-0538
Fax
(909) 476-0530
NPI assigned
Sep 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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 110600 CA Primary

Addresses

Primary practice location

11819 Foothill Blvd Ste G
Rancho Cucamonga, CA 91730-3939

Mailing address

11819 Foothill Blvd Ste G
Rancho Cucamonga, CA 91730-3939
Phone (909) 695-8221

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
I20250924002555 CA Order and Referring Only - DentistPractitioner - Dentist 2264937986

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1568296473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11819 FOOTHILL BLVD STE G",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303939",
            "telephone_number": "909-695-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11819 FOOTHILL BLVD STE G",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917303939",
            "telephone_number": "909-476-0538",
            "fax_number": "909-476-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGHIRAN",
        "first_name": "MEGAN KAYE",
        "middle_name": "MATIBAG",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-02",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cucamonga, CA

Sources for this page

Verify at the official NPI Registry.