Active NPI
Antoine S. Sayegh, D.D.S.
- Prosthodontics
- Glendora, CA
National Provider Identifier
1831177369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 40725
- Practice address
- 707 W Route 66
Suite 102
Glendora, CA 91740-4134 - Phone
- (626) 963-7581
- Fax
- (626) 963-2847
- NPI assigned
- Jan 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 40725 | CA | Primary |
Addresses
Primary practice location
707 W Route 66
Suite 102
Glendora, CA 91740-4134
Mailing address
707 W Route 66
Suite 102
Glendora, CA 91740-4134
Phone (626) 963-7581
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150701002842 | CA | Order and Referring Only - Oral Surgery | 3072825165 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40725 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1340236800000",
"number": "1831177369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 W ROUTE 66",
"address_2": "SUITE 102",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404134",
"telephone_number": "626-963-7581",
"fax_number": "626-963-2847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 W ROUTE 66",
"address_2": "SUITE 102",
"city": "GLENDORA",
"state": "CA",
"postal_code": "917404134",
"telephone_number": "626-963-7581",
"fax_number": "626-963-2847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAYEGH",
"first_name": "ANTOINE",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-05",
"last_updated": "2012-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "CA",
"license": "40725",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.