Siamak Afshar, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50717 Issued in CA

Practice address

11623 Cherry Ave
Suite B-2
Fontana, CA 92337-1212

Phone

(909) 355-1485

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689718108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 LARRY DEAN ST",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928803150",
            "telephone_number": "909-923-9724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11623 CHERRY AVE",
            "address_2": "SUITE B-2",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923371212",
            "telephone_number": "909-355-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AFSHAR",
        "first_name": "SIAMAK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50717",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Rose Adkisson, MA, MFT
• Advik Medical Transport LLC
• Timothy Estaban Afable, PHARMD
• Arman Afagh, MD
• Tolulope Afolabi, MS, DPM
• Akash Agarwal
• Samuel Agbonkpolo
• Anthony Aghajani, MD
• Richel P Agra
• Alejandra Aguiar

• General Practice Dentistry in Fontana, CA
• Providers in Fontana, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.