Individual provider Active NPI

Kanza Tauqir, DMD

  • Dentist
  • Upland, CA
National Provider Identifier
1720699556
Registry record updated Mar 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107161 Issued in CA
Practice address
1875 N Campus Ave Ste C
Upland, CA 91784-8211
Phone
(909) 985-2302
NPI assigned
Aug 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2022

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 DN1858782 MA
Dentist 122300000X 107161 CA Primary

Addresses

Primary practice location

1875 N Campus Ave Ste C
Upland, CA 91784-8211

Mailing address

1875 N Campus Ave Ste C
Upland, CA 91784-8211
Phone (909) 985-2302

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
107161CAMDDentist
DN1858782MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Louis Stromberg Professional Dental Corporation General Practice PastSince Feb 24, 2022 Accepting new patients
Bedford Dental Arts, LLC Dentist PastSince Aug 1, 2020 Accepting new patients

Organizations & group practices 2

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": "1597363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646956800000",
    "number": "1720699556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1875 N CAMPUS AVE STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917848211",
            "telephone_number": "909-985-2302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 N CAMPUS AVE STE C",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917848211",
            "telephone_number": "909-985-2302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAUQIR",
        "first_name": "KANZA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-14",
        "last_updated": "2022-03-11",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858782",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2022; 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.