Sambath Sem Tiep, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

58916 Issued in CA

Practice address

15725 Pomerado Rd Ste 206
Poway, CA 92064-2059

Phone

(858) 251-3313

Fax

(858) 225-1803

NPI assigned

Dec 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Sambath Tiep DDS, PC

  • Pediatric Dentistry
  • Poway, CA
  • NPI 1548804313
  NPD Authorized official

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

{
    "created_epoch": "1259625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1598093643",
    "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",
            "fax_number": "858-225-1803"
        },
        {
            "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": {
        "last_name": "TIEP",
        "first_name": "SAMBATH",
        "middle_name": "SEM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-01",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "58916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xavier Daoedsjah Thompson
• Shelby Jean Thorpe, PH.D.
• Thrive at Home
• Thrive RX Specialty Pharmacy Corporation
• Jeffrey Tien, L.AC, DIPL.OM
• Brita Tiik
• Timothy Maresh MD, Inc,.
• Tram To-Nguyen
• Ling Tong
• Diana Torres

• 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 Mar 20, 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.