Active NPI
Sheeva Ahmadian, D.M.D.
- Dentist
- Thousand Oaks, CA
National Provider Identifier
1598129405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 100915
- Practice address
- 61 Long CT
Suite #110
Thousand Oaks, CA 91360 - Phone
- (617) 528-0044
- NPI assigned
- Apr 6, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 100915 | CA | Primary |
Addresses
Primary practice location
61 Long CT
Suite #110
Thousand Oaks, CA 91360
Mailing address
5627 Kanan Rd # 136
Agoura Hills, CA 91301-3358
Phone (617) 528-0044
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170421001042 | CA | Order and Referring Only - Dentist | 1052697331 |
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": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653264000000",
"number": "1598129405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5627 KANAN RD # 136",
"city": "AGOURA HILLS",
"state": "CA",
"postal_code": "913013358",
"telephone_number": "617-528-0044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 LONG CT",
"address_2": "SUITE #110",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "91360",
"telephone_number": "617-528-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMADIAN",
"first_name": "SHEEVA",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-06",
"last_updated": "2022-05-23",
"certification_date": "2021-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100915",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.