Individual provider Active NPI

Samira Sahar Darbandi, DDS

  • Dentist
  • Temecula, CA
National Provider Identifier
1891477733
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
108911 Issued in CA
Practice address
31843 Rancho California Rd Ste 300
Temecula, CA 92591-5120
Phone
(951) 676-2613
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 108911 CA Primary

Addresses

Primary practice location

31843 Rancho California Rd Ste 300
Temecula, CA 92591-5120

Mailing address

30147 Rancho California Rd Apt 726
Temecula, CA 92592-5496
Phone (918) 852-7205

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
I20240129001305 CA Order and Referring Only - DentistPractitioner - Dentist 1052764842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108911CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Chu and Watanabe Dental Corporation PastSince Aug 6, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1891477733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30147 RANCHO CALIFORNIA RD APT 726",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925925496",
            "telephone_number": "918-852-7205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31843 RANCHO CALIFORNIA RD STE 300",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925915120",
            "telephone_number": "951-676-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DARBANDI",
        "first_name": "SAMIRA",
        "middle_name": "SAHAR",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "108911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.