Individual provider Active NPI

Ian Shwartzman, DDS

  • Dentist
  • San Bernardino, CA
National Provider Identifier
1710072103
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
49671 Issued in CA
Practice address
330 N D St
Suite# 360
San Bernardino, CA 92401-1545
Phone
(909) 475-5564
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 49671 CA Primary

Addresses

Primary practice location

330 N D St
Suite# 360
San Bernardino, CA 92401-1545

Mailing address

330 N D St
Suite #360
San Bernardino, CA 92401-1545
Phone (909) 475-5564

Other identifiers 1

IdentifierTypeStateIssuer
G92431-01OtherCADENTI CAL

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

State licenses

LicenseStateTypeSpecialty
49671CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
I.Shwrtzman,DDS,Inc CurrentSince Nov 15, 2020 Accepting new patients

Locations

330 N D St
Ste 360
San Bernardino, CA 92401
Phone (909) 475-5564

Organizations & group practices 1

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1710072103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 N D ST",
            "address_2": "SUITE #360",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011545",
            "telephone_number": "909-475-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 N D ST",
            "address_2": "SUITE# 360",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924011545",
            "telephone_number": "909-475-5564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHWARTZMAN",
        "first_name": "IAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "49671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI CAL",
            "identifier": "G92431-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; 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.