Individual provider Active NPI

Samyeh Vahabi, D.D.S.

  • Endodontics
  • Chino Hills, CA
National Provider Identifier
1841474996
Registry record updated Nov 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
56559 Issued in CA
Practice address
5771 Pine Ave
Ste S
Chino Hills, CA 91709-6529
Phone
(909) 597-2477
NPI assigned
Dec 26, 2007
Last updated
Nov 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 56559 CA Primary
General Practice Dentistry 1223G0001X 56559 CA

Addresses

Primary practice location

5771 Pine Ave
Ste S
Chino Hills, CA 91709-6529

Mailing address

5771 Pine Ave
Ste S
Chino Hills, CA 91709-6529
Phone (909) 597-2477

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812009228 CA Order and Referring Only - DentistPractitioner - Dentist 2163737685

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56559CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Gupta Gill Abdolhosseini DDS Inc General Practice Past Accepting new patients
Abdolhosseini, DDS Inc General Practice PastSince Sep 14, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1198627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1841474996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5771 PINE AVE",
            "address_2": "STE S",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096529",
            "telephone_number": "909-597-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5771 PINE AVE",
            "address_2": "STE S",
            "city": "CHINO HILLS",
            "state": "CA",
            "postal_code": "917096529",
            "telephone_number": "909-597-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAHABI",
        "first_name": "SAMYEH",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-26",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "56559",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "56559",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chino Hills, CA

Sources for this page

Verify at the official NPI Registry.