Individual provider Active NPI

Payam Ata Sanjideh, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Calabasas, CA
National Provider Identifier
1649469768
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
56201 Issued in CA
Practice address
23487 Park Colombo
Calabasas, CA 91302-2814
Phone
(310) 435-7449
NPI assigned
Oct 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 56201 CA Primary

Addresses

Primary practice location

23487 Park Colombo
Calabasas, CA 91302-2814

Mailing address

23487 Park Colombo
Calabasas, CA 91302-2814
Phone (310) 435-7449

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
56201CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1649469768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23487 PARK COLOMBO",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913022814",
            "telephone_number": "310-435-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23487 PARK COLOMBO",
            "city": "CALABASAS",
            "state": "CA",
            "postal_code": "913022814",
            "telephone_number": "310-435-7449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANJIDEH",
        "first_name": "PAYAM",
        "middle_name": "ATA",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-15",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "56201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Calabasas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.