Individual provider Active NPI

Ahmed Saad

  • Dentist
  • Rialto, CA
National Provider Identifier
1811340573
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107178 Issued in CA
Practice address
1315 Renaissance Pkwy # 870
Rialto, CA 92376-2406
Phone
(909) 434-1000
NPI assigned
Jul 18, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 107178 CA Primary

Addresses

Primary practice location

1315 Renaissance Pkwy # 870
Rialto, CA 92376-2406

Mailing address

1369 Country Place Dr
Houston, TX 77079-3125
Phone (267) 315-3373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20160916002203 CT Order and Referring Only - DentistPractitioner - Dentist 8729375852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107178CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639699200000",
    "number": "1811340573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1369 COUNTRY PLACE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793125",
            "telephone_number": "267-315-3373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 RENAISSANCE PKWY # 870",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "923762406",
            "telephone_number": "909-434-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAAD",
        "first_name": "AHMED",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-18",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

Verify at the official NPI Registry.