Maryam Waheed, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1861869976 Issued in CA

Practice address

22373 El Toro Rd
Lake Forest, CA 92630

Phone

(949) 444-5833

NPI assigned

Aug 24, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ardalan Dental Group Corp

  • General Practice Dentistry
  • Anaheim, CA
  • NPI 1063974244
  Medicare reassignment NPD Authorized official
• Maryam Waheed Dental Group Corp

  • General Practice Dentistry
  • Lake Forest, CA
  • NPI 1932676699
  Medicare reassignment NPD Authorized official
• Waheed M Dental of West Covina Corp

  • Dentist
  • West Covina, CA
  • NPI 1750010310
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699488000000",
    "number": "1861869976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22373 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22373 EL TORO RD",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "92630",
            "telephone_number": "949-444-5833"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8268 164th St",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114321121",
            "country_code": "US",
            "telephone_number": "718-883-3270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHEED",
        "first_name": "MARYAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-24",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "1861869976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Vu
• Timothy Vu, MD
• Veronica Vu, PHARM.D.
• Melody Ann Vujicich, RDHAP
• Hanna Wagner, OTR/L
• Walgreen Co
• Walgreen Co
• Aidan Walker-Butler
• Kelly Michelle Walker, PHARMD
• Dina Christine Wallace

• Dentist in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2023; 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.

Verify at the official NPI Registry.