Individual provider Active NPI

Amirhossein Bahador

  • General Practice Dentistry
  • Oxnard, CA
National Provider Identifier
1689494965
Registry record updated Nov 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110932 Issued in CA
Practice address
801 Cooper Rd
Oxnard, CA 93030-5445
Phone
(805) 330-8100
Fax
(805) 240-7383
NPI assigned
Oct 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.035463 IL
General Practice Dentistry 1223G0001X 110932 CA Primary

Addresses

Primary practice location

801 Cooper Rd
Oxnard, CA 93030-5445

Mailing address

1040 Flynn Rd
Camarillo, CA 93012-5092
Phone (805) 673-3930

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
I20241023000561 CA Practitioner - Dentist 4385177815 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
019.035463ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
St. Johns Community Health CurrentSince Oct 21, 2024 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Dec 1, 2024 Accepting new patients
St. Johns Community Health CurrentSince Oct 21, 2024 Accepting new patients
St. Johns Community Health Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Dec 1, 2024 Accepting new patients
Clinicas del Camino Real Inc PastSince Dec 1, 2024 Accepting new patients
St. Johns Community Health Past Accepting new patients

Locations

1040 Flynn Rd
Camarillo, CA 93012
Phone (805) 673-3930

2115 N Wilmington Ave
Compton, CA 90222
Phone (310) 603-1332

801 Cooper Rd
Oxnard, CA 93030
Phone (805) 330-8100

1821 S San Jacinto Ave
Ste D
San Jacinto, CA 92583
Phone 32328598302332

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

1500 N Waterman Ave
Sn Bernrdno, CA 92404
Phone (909) 381-1591

Interoperability endpoints

  • Direct secure messaging: abahador802583@direct.ochin.org
  • Direct secure messaging: amirhossein.bahador.p1@direct.clinicas.nextgenshare.com

Organizations & group practices 8

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": "1728691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1689494965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 FLYNN RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125092",
            "telephone_number": "805-673-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 COOPER RD",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930305445",
            "telephone_number": "805-330-8100",
            "fax_number": "805-240-7383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHADOR",
        "first_name": "AMIRHOSSEIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-12",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.035463",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxnard, CA

Sources for this page

Verify at the official NPI Registry.