Individual provider Active NPI

Samuel Babikian, DDS

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1629750484
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
109045 Issued in CA
Practice address
164 W Hospitality LN Ste 127
San Bernardino, CA 92408-3351
Phone
(909) 453-6600
NPI assigned
Aug 2, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 109045 CA Primary

Addresses

Primary practice location

164 W Hospitality LN Ste 127
San Bernardino, CA 92408-3351

Mailing address

1851 E Woodlyn Rd
Pasadena, CA 91104-3242
Phone (626) 797-0154

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
I20250404000120 CA Practitioner - Dentist 6709317027 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109045CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Community Health Centers, Inc CurrentSince Feb 17, 2025 Accepting new patients
Comprehensive Community Health Centers Inc CurrentSince Feb 17, 2025 Accepting new patients
Feldkamp Cal Select Dental Group, Inc. CurrentSince Aug 6, 2023 Accepting new patients

Locations

801 S Chevy Chase Dr
Ste 250
Glendale, CA 91205
Phone (818) 265-2259

1704 Colorado Blvd
Los Angeles, CA 90041
Phone (323) 256-4116

164 W Hospitality Ln
Ste 127
San Bernardino, CA 92408
Phone (909) 453-6600

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1690934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1629750484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 E WOODLYN RD",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911043242",
            "telephone_number": "626-797-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 W HOSPITALITY LN STE 127",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083351",
            "telephone_number": "909-453-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABIKIAN",
        "first_name": "SAMUEL",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-02",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "109045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.