Safaeddin Jahanbani, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

45376 Issued in CA

Practice address

661 W 1St St
Ste a
Tustin, CA 92780-2939

Phone

(714) 665-1175

Fax

(714) 665-1179

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

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.

• Families Together of Orange County

  • Clinic/Center
  • Tustin, CA
  • NPI 1194122457
  Medicare reassignment NPD
• Families Together of Orange County

  • Federally Qualified Health Center (FQHC)
  • Tustin, CA
  • NPI 1861253080
  NPD
• Universa Medica Healh ,Inc

  • Family Medicine Physician
  • Santa Ana, CA
  • NPI 1114269404
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1629139811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST",
            "address_2": "STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-1175",
            "fax_number": "714-665-1179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 W 1ST ST",
            "address_2": "STE A",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "927802939",
            "telephone_number": "714-665-1175",
            "fax_number": "714-665-1179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAHANBANI",
        "first_name": "SAFAEDDIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "45376",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B45376-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jack Y Pai Dental Group
• Bernice Jana Jacob, FNP
• Shannon Nicole Jacquez-Jaramillo, CCC-SLP
• Jae Hee Kwak DMD Inc
• Jennifer Jaeger, MS
• Sara Jahangiri
• Vijay Jain, DMD
• Jamboree Optometry Inc
• Jamellow LLC (West Coast Sleep Centers)
• James Q Bui DDS a Professional Dental Corporation

• General Practice Dentistry in Tustin, CA
• Providers in Tustin, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.

Verify at the official NPI Registry.