Organization Active NPI

Sam Saadat DDS a Professional Corporation

  • Dentist
  • Newbury Park, CA
National Provider Identifier
1679023048
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
58415 Issued in CA
Legal business name
SAM SAADAT DDS A PROFESSIONAL CORPORATION
Doing business as
Newbury Smiles
Practice address
3327 Kimber Dr
Suite D
Newbury Park, CA 91320-4315
Phone
(805) 499-3691
Fax
(805) 499-4652
NPI assigned
Oct 10, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Authorized official

Name
Dr. Sam Saadat
Title
Dentist/Owner
Phone
(805) 499-3691

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 58415 CA Primary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X 59390 CA
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 55438 CA

Addresses

Primary practice location

3327 Kimber Dr
Suite D
Newbury Park, CA 91320-4315

Mailing address

3327 Kimber Dr
Suite D
Newbury Park, CA 91320-4315
Phone (805) 499-3691

Other names 1

  • Newbury Smiles Doing business as

National Provider Directory

National Provider Directory

Locations

3327 Kimber Dr
Ste D
Newbury Park, CA 91320
Phone (805) 499-3691

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476057600000",
    "number": "1679023048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3327 KIMBER DR",
            "address_2": "SUITE D",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204315",
            "telephone_number": "805-499-3691",
            "fax_number": "805-499-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3327 KIMBER DR",
            "address_2": "SUITE D",
            "city": "NEWBURY PARK",
            "state": "CA",
            "postal_code": "913204315",
            "telephone_number": "805-499-3691",
            "fax_number": "805-499-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAM SAADAT DDS A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A",
        "authorized_official_last_name": "SAADAT",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "805-499-3691",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "58415",
            "primary": true
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "59390",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "55438",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newbury Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newbury Park, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.