Active NPI
Ahmed Saad
- Dentist
- Rialto, CA
National Provider Identifier
1811340573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 107178
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160916002203 | CT | Order and Referring Only - Dentist | 8729375852 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107178 | CA | MD | Dentist |
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.