Individual provider Active NPI

Steven Carl Sanders, DDS

  • Prosthodontics
  • Glendale, CA
National Provider Identifier
1578906194
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
21943 Issued in CA
Practice address
428 Arden Ave
Suite 201
Glendale, CA 91203-1108
Phone
(818) 243-4287
NPI assigned
Apr 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 21943 CA Primary

Addresses

Primary practice location

428 Arden Ave
Suite 201
Glendale, CA 91203-1108

Mailing address

9941 McBroom St
Suite 201
Sunland, CA 91040-1657
Phone (818) 243-4287

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
I20150707002818 CA Order and Referring Only - DentistPractitioner - Dentist 4183936925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21943CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ariel J. Rodriguez, DDS, a Professional Dental Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1578906194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9941 MCBROOM ST",
            "address_2": "SUITE 201",
            "city": "SUNLAND",
            "state": "CA",
            "postal_code": "910401657",
            "telephone_number": "818-243-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 ARDEN AVE",
            "address_2": "SUITE 201",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912031108",
            "telephone_number": "818-243-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "STEVEN",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-12",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "21943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.