Active NPI
Bita Moghaddas, DDS
- Endodontics
- Santa Ana, CA
National Provider Identifier
1760557474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 53311
- Practice address
- 3500 S Bristol St
Suite 100
Santa Ana, CA 92704-7319 - Phone
- (714) 957-6030
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 53311 | CA | Primary |
Addresses
Primary practice location
3500 S Bristol St
Suite 100
Santa Ana, CA 92704-7319
Mailing address
PO Box 10612
Newport Beach, CA 92658-5002
Phone (310) 927-0552
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53311 | CA | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760557474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10612",
"city": "NEWPORT BEACH",
"state": "CA",
"postal_code": "926585002",
"telephone_number": "310-927-0552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 S BRISTOL ST",
"address_2": "SUITE 100",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927047319",
"telephone_number": "714-957-6030"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOGHADDAS",
"first_name": "BITA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CA",
"license": "53311",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.