Individual provider Active NPI

Suzan Sabagh, DDS

  • Orofacial Pain Dentistry
  • Los Angeles, CA
National Provider Identifier
1649440595
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
48671 Issued in CA
Practice address
11980 San Vicente Blvd Ste 814
Los Angeles, CA 90049-6606
Phone
(760) 436-6365
NPI assigned
Mar 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 48671 CA
Pain Medicine Physician 208VP0000X 48671 CA
Orofacial Pain Dentistry 1223X2210X 48671 CA Primary

Addresses

Primary practice location

11980 San Vicente Blvd Ste 814
Los Angeles, CA 90049-6606

Mailing address

16501 Falda Ave Ste L
Torrance, CA 90504-1412
Phone (310) 493-1133

Other practice location 1

2424 W Ball Rd
Suite L
Anaheim, CA 92804-5272
Phone (714) 826-9000

Other practice location 2

4403 Manchester Ave Ste 101
Encinitas, CA 92024-4939
Phone (844) 235-9881

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
I20250114001153 CA Practitioner - Dentist 1557899879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Herman Ostrow School of Dentistry of Usc, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bradley a Eli Dental CorporationGroup PAC ID 1557682804, 5 clinicians

Practice addresses (Care Compare)

2095 W Vista Way
Suite 218
Vista, CA 92083-6029
Phone (760) 436-6365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
48671CAMDPain Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Great Lakes Sleep and Orofacial Pain Clinic Oral and Maxillofacial Surgery Current Accepting new patients
Bradley a. Eli Dental Corporation Oral and Maxillofacial Surgery CurrentSince Jan 6, 2025 Accepting new patients
Sleep Treatment Partners CurrentSince Jun 1, 2022 Accepting new patients
Bradley Eli la Office Oral and Maxillofacial Surgery CurrentSince May 28, 2023 Accepting new patients
Dabbagh and Al Teir Dental Corporation General Practice PastSince May 15, 2019 Accepting new patients

Locations

4403 Manchester Ave
Ste 101
Encinitas, CA 92024
Phone (760) 436-6365

11980 San Vicente Blvd
Ste 814
Los Angeles, CA 90049
Phone (760) 436-6365

1964 Westwood Blvd
Ste 200
Los Angeles, CA 90025
Phone (310) 446-4867

11980 San Vicente Blvd
Los Angeles, CA 90049
Phone (310) 820-1496

11980 San Vicente Blvd
Ste 811
Los Angeles, CA 90049
Phone (310) 826-8911

2095 W Vista Way
Ste 218
Vista, CA 92083
Phone (760) 630-3562

Interoperability endpoints

  • Direct secure messaging: suzan.sabagh.1@15735.direct.athenahealth.com

Organizations & group practices 5

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": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759708800000",
    "number": "1649440595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16501 FALDA AVE STE L",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905041412",
            "telephone_number": "310-493-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11980 SAN VICENTE BLVD STE 814",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900496606",
            "telephone_number": "760-436-6365"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2424 W Ball Rd",
            "address_2": "SUITE L",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928045272",
            "country_code": "US",
            "telephone_number": "714-826-9000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4403 Manchester Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920244939",
            "country_code": "US",
            "telephone_number": "844-235-9881",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABAGH",
        "first_name": "SUZAN",
        "name_prefix": "Ms.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "48671",
            "primary": false
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "CA",
            "license": "48671",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "CA",
            "license": "48671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.