Individual provider Active NPI

Tamim Sediq

  • Dentist
  • Northridge, CA
National Provider Identifier
1720482276
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63969 Issued in CA
Practice address
18519 Devonshire St
Northridge, CA 91324-1308
Phone
(818) 831-9990
NPI assigned
Oct 13, 2014
Last updated
Oct 13, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63969 CA Primary

Addresses

Primary practice location

18519 Devonshire St
Northridge, CA 91324-1308

Mailing address

18519 Devonshire St
Northridge, CA 91324-1308
Phone (818) 831-9990

Other names 1

  • Dr. Tommy Sediq Other name

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
I20150814014752 CA Order and Referring Only - DentistPractitioner - Dentist 9830404128

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
63969CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Charles Rodgers Professional Dental Corporation Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1720482276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18519 DEVONSHIRE ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241308",
            "telephone_number": "818-831-9990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18519 DEVONSHIRE ST",
            "city": "NORTHRIDGE",
            "state": "CA",
            "postal_code": "913241308",
            "telephone_number": "818-831-9990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDIQ",
        "first_name": "TAMIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOMMY",
            "last_name": "SEDIQ",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northridge, CA

Sources for this page

Verify at the official NPI Registry.